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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 1, January-February 2020, Pages 354-360
 

Original Article

Comparative Study to Evaluate the Efficacy of Intrathecal Clonidine Versus Clonidine with Fentanyl in Laparoscopic Surgeries Under General Anaesthesia

Surekha C1, Nazneen Makhbool2, Anurita Konnur3

1Assistant Professor 2Post Graduate Student 3Assistant Professor, Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka 560002, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.48

Abstract

Background: Laparoscopic surgeries are known to cause hemodynamic repercussions due to pneumoperitoneum despite being minimally invasive surgeries. Various studies have been conducted to minimize hemodynamic alterations in laparoscopic surgeries. Aim: The aim was to compare the efficacy of intrathecal clonidine versus intrathecal clonidine with fentanyl in maintaining hemodynamic stability and to assess postoperative analgesia in patients undergoing laparoscopic surgeries under general anesthesia. Materials and Methods: A randomized double-blind study was done in 60 patients of either sex, with American Society of Anesthesiologists Grade I and II, aged between 18 and 55, posted for laparoscopic surgeries. Group CL (n = 30) received intrathecal clonidine 150 micrograms and Group CF (n = 30) received intrathecal clonidine 75 micrograms followed by intrathecal fentanyl 25 micrograms before general anesthesia. Assessment parameters included hemodynamics, postoperative analgesia and sedation scores. Results: Intraoperative heart rate, systolic, diastolic and mean arterial blood pressures at intubation, pneumoperitoneum and extubation were significantly reduced in Group CL (p < 0.05) when compared to Group CF. Mean duration of postoperative analgesia was significantly prolonged in Group CL (10.30 ± 1.24 hours, p < 0.001) when compared to Group CF (5.53 ± 1.11 hours). Mean sedation score was significantly higher in Group CL (2.07 ± 0.25 versus 1.90 ± 0.31; p = 0.025). No adverse effects were recorded during study. Conclusions: Intrathecal clonidine 150 micrograms is highly effective in maintaining intraoperative hemodynamic stability during laparoscopic surgeries under general anesthesia along with prolonged postoperative analgesia in comparison to combination of intrathecal clonidine 75 micrograms with fentanyl 25 micrograms.


Keywords : Intrathecal Clonidine; Fentanyl; Hemodynamics; Analgesia.
Corresponding Author : Nazneen Makhbool