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Clonidine versus Tramadol as Adjuvant to Epidural Anaesthesia With 0.5% Bupivacaine for Lower Limb Orthopaedic Procedures

Kumkum Gupta, Professor, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami Vivekanand Subharti University, NH-58, By Pass Road, Meerut-UP, India, Pavitra Kalra, Prashant K Gupta, Salony Agarwal, Abhishake Kumar, Iqraa Khanum, Resident, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India, Director &Professor, Department of Radio diagnosis and Imaging,Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India, Associate Professor, Department of Anaesthesiology and critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India, Assistant Professor, Department of Anaesthesiology and critical care,Subharti Medical College, Swami Vivekanand Subharti University, NH-58, By Pass Road, Meerut-UP, India, Senior Resident, Department of Anaesthesiology and critical care, Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India
2019 Academia Anesthesiologica International  

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Epidural anesthesia is safe to provide surgical anesthesia and postoperative analgesia. Its efficacy can be improved with diversity of adjuvants. The aim of the study was to compare the clonidine versus tramadol as epidural adjuvant to 0.5% bupivacaine for lower limb orthopaedic procedures. Subjects and Methods: Sixty adult patients were enrolled and divided in two equal groups of 30 patients each to receive 14 mL of 0.5% bupivacaine with either1ml (50µg) clonidine (Group I) or 1ml (50mg)
more » ... ol (Group II), through lumbar epidural catheter at L3-L4 intervertebral space.The onset and duration of sensory and motor blockade with highest cephalic spread and duration of postoperative analgesia were assessed as primary objectives. Hemodynamic changes, respiration, sedation level or any adverse events were assessed as secondary end points. Results: Mean onset time and two dermatome sensory regression was comparable. The mean duration of sensory analgesia was 216.08±46.18mininpatientsof Group I and 251.33 ± 58.5 min in patients of Group II with statistically highly significant difference between the groups (P=0.000). Mean onset time and duration of motor blockade was comparable. The hemodynamic parameters remained stable, though 4 patients of Group I developed manageable hypotension. No episode of respiratory depression, shivering, pruritus, nausea and vomiting was observed. Conclusion: Tramadol (50mg) as epidural adjuvantto0.5%bupivacainewas better than clonidine for enhancing the duration of postoperative analgesia in patients undergoing lower limb orthopedic procedures.
doi:10.21276/aan.2019.4.2.37 fatcat:23v2metskzhd5gkxvmp5tymz4u
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Kumkum Gupta, Professor, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami Vivekanand Subharti University, NH-58, By Pass Road, Meerut-UP, India, Pavitra Kalra, Prashant K Gupta, Salony Agarwal, Abhishake Kumar, Iqraa Khanum, Resident, Department of Anaesthesiology and Critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India, Director &Professor, Department of Radio diagnosis and Imaging,Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India, Associate Professor, Department of Anaesthesiology and critical care,Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India, Assistant Professor, Department of Anaesthesiology and critical care,Subharti Medical College, Swami Vivekanand Subharti University, NH-58, By Pass Road, Meerut-UP, India, Senior Resident, Department of Anaesthesiology and critical care, Subharti Medical College, Swami VivekanandSubharti University, NH-58, By Pass Road, Meerut-UP, India. "Clonidine versus Tramadol as Adjuvant to Epidural Anaesthesia With 0.5% Bupivacaine for Lower Limb Orthopaedic Procedures." Academia Anesthesiologica International 4.2 (2019) 164-169