A Study on Effect of Oral Clonidine Premedication on Onset and duration of Spinal Anaesthesia by Hyperbaric 0.5% Bupivacaine

Sureshu, P (2006) A Study on Effect of Oral Clonidine Premedication on Onset and duration of Spinal Anaesthesia by Hyperbaric 0.5% Bupivacaine. Masters thesis, Stanley Medical College, Chennai.

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Abstract

INTRODUCTION: Among all the regional anesthesia techniques subarachnoid block is the easiest to perform because of its clearly defined end point and it is most widely used for surgeries below the umbilicus and lower extremities. The advantages of subarachnoid block are reduced blood loss, attenuation of neuroendocrine response, increase blood flow to lower limbs, decreased platelet aggregation, well maintained airway in a conscious patients reduced mortality and marked decrease in hospital cost. In order to prolong the duration of subarachnoid block vasoconstrictors were added to local anesthetics but one of the rare outcomes is ischemia of spinal cord. Hence the need to find a drug which do not damage the spinal cord but at the same time should effectively prolong the duration of spinal anaesthesia could be an α2 agonist clonidine which inhibit nerve conduction in Aα and C fibers without causing ischemic damage to spinal cord. AIM OF THE STUDY: 1. To assess whether oral clonidine affects the onset and duration of subarachnoid block by 0.5% hyperbaric bupivacaine. 2. To assess whether oral clonidine affects the onset and duration of subarachnoid block by 0.5% hyperbaric bupivacaine in a dose related manner. 3. To evaluate the side effects and complications that may arise with the use of oral clonidine. MATERIALS AND METHODS: This is a prospective, randomized, double blinded, control study. Prior approval was obtained from the ethical committee of Government Stanley Medical College and Hospital. The procedure and complications of regional analgesia was explained to them in detail and written consent was obtained from them. Inclusion criteria: 1. Patients belonging to ASA I and ASA II, 2. Age 20-50 yrs, 3. Elective lower limb and lower abdominal surgeries under spinal anaesthesia. Exclusion criteria: 1. DM, bleeding disorder or other systemic disorders. 2. Patients who have already received any Opioid drugs or systemic analgesics within prior 24 hours. 3. Any contraindication for central neuraxial techniques. 4. Patients with known allergy to local anaesthetic or other drugs. 5. Patient refusal for regional technique. 6. Patients belonging to ASA3 and ASA4. CONCLUSION: Pretreatment with 100 micrograms & 150 micrograms of clonidine hydrochloride administered orally 60 minutes prior to spinal anaesthesia with 0.5% hyperbaric bupivacaine. 1. Hastens the onset of sensory blockade but does not affect the onset of motor blockade. 2. Prolongs the duration of both sensory and motor blockade. 3. Produces significantly higher incidence of mild sedation intraoperatively. 4. The duration of both sensory and motor blockade is increased when premedicated with 150 microgram of clonidine compare to 100 microgram of clonidine with the side effects comparable in both the groups. 5. Is not associated with any greater change in heart rate and blood pressure than that seen following spinal anaesthesia without clonidine premedication.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Oral Clonidine Premedication ; Onset ; Spinal Anaesthesia ; Hyperbaric 0.5% Bupivacaine.
Subjects: MEDICAL > Anaesthesiology
Depositing User: Subramani R
Date Deposited: 22 Apr 2018 15:31
Last Modified: 28 Apr 2018 04:30
URI: http://repository-tnmgrmu.ac.in/id/eprint/7229

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