Comparison of Effect of Epidural Bupivacaine, Epidural Bupivacaine Plus Fentanyl and Epidural Bupivacaine Plus Clonidine on Postoperative Analgesia after Hip Surgery
- *Corresponding Author:
- Dr. Rakesh Karnawat
Professor, Department of Anaesthesiology
Dr S N Medical College, Jodhpur, Rajasthan, India
E-mail: [email protected]
Received date: May 13, 2013;; Accepted date: December 19, 2013; Published date: December 21, 2013
Citation:Karnawat R, Chhabra S, Mohammed S, Paliwal B (2013) Comparison of Effect of Epidural Bupivacaine, Epidural Bupivacaine Plus Fentanyl and Epidural Bupivacaine Plus Clonidine on Postoperative Analgesia after Hip Surgery. J Anesth Clin Res 4:373. doi: 10.4172/2155-6148.1000373
Copyright: © 2013 Karnawat R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Management of postoperative pain is one of the most challenging and gratifying domains of anaesthesia. Search for an ideal adjuvant for post operative epidural analgesia still continues.
Methods: A total of 75 healthy patients of both sexes in age group 50-80 years belonging to ASA status I and II posted for elective hip surgeries were enrolled and randomly divided into three groups of 25 each - Group B, Group BF and Group BC All the patients in the three groups received 3.5 ml Bupivacaine heavy (0.5%) intrathecally before surgery, followed by epidural bolus postoperatively, at ‘two segment sensory regression’ in following manner: initial bolus made to 10 ml with each group given - 7 ml of 0.125% Bupivacaine and 3 ml distilled water with adjuvant as 50 μg Fentanyl in group BF and 100 μg Clonidine in group BC. Top up of 7 ml was given to each group with 5 ml of 0.125% Bupivacaine and 2 ml distilled water with adjuvant as 50 μg Fentanyl in group BF and 75 μg Clonidine in group BC.
Results: There was no statistically significant difference between the demographic profile. VAS scores were found to be better in Group BF and BC at most of the times and these scores were significantly lower than Group B. Rescue analgesia was required in 12% patients in Group B while none of the patients in Group BF or Group BC required rescue analgesia. Nausea, vomiting and pruritus were observed in 52% of the patients in Group BF and in none of the patients in Group BC and Group B.Degree of sedation was significantly more in Group BC when compared with Group BF and Group B.
Conclusion: Combination of Bupivacaine-Clonidine was found to be a better option than Bupivacaine-Fentanyl for postoperative epidural analgesia in hip surgery patients.