Dash Umesh K, Kiran S, Tandon Urvashi, Jinjil Kavitha
Department of Anaesthesiology and Critical Care, INHS Asvini, Mumbai, Maharashtra, India.
Anesth Essays Res. 2016 Sep-Dec;10(3):618-623. doi: 10.4103/0259-1162.191114.
The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established.
This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia.
A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital.
Sixty patients were divided randomly into two groups, Group C and Group F. Patients in Group C received 2.5 ml of 0.5% bupivacaine heavy mixed with 0.5 ml (75 μg) clonidine intrathecally, and patients in Group F received 2.5 ml of 0.5% bupivacaine heavy mixed with 0.5 ml (25 μg) fentanyl intrathecally.
Data were analyzed using statistical tests for comparison of means.
The mean durations of sensory block was 253.3 and 249.6 minutes in group C and group F respectively, which was statistically not significant ( = 0.76). The mean durations of motor block were 302.3 and 293.6 min, respectively, in Group C and Group F, which were also statistically not significant ( = 0.53). The mean durations of postoperative analgesia were 653.4 and 611.2 min, respectively, in Group C and Group F, which were statistically not significant ( = 0.09). Mean heart rate after 10 min was 82.5 in Group C and 87.2 in Group F, which was statistically not significant ( = 0.29), and mean arterial pressure in mmHg after 10 min was 96.3 in Group C and 97.3 in Group F, which was also statistically not significant ( = 0.86).
Both clonidine 75 μg and fentanyl 25 μg when used as adjuvants to bupivacaine in the subarachnoid block have comparable beneficial results in terms of duration of analgesia, duration of motor blocks, and hemodynamic stability and also have a comparable incidence of complications.
布比卡因等局部麻醉剂与阿片类药物和可乐定等鞘内佐剂之间的协同作用已得到充分证实。
本研究评估75μg可乐定与25μg芬太尼作为布比卡因蛛网膜下腔麻醉佐剂的临床疗效。
在一家三级护理医院进行了为期12个月的前瞻性、随机、平行组研究。
60例患者随机分为两组，C组和F组。C组患者鞘内注射2.5ml 0.5%重比重布比卡因与0.5ml（75μg）可乐定混合液，F组患者鞘内注射2.5ml 0.5%重比重布比卡因与0.5ml（25μg）芬太尼混合液。
采用均值比较的统计检验方法对数据进行分析。
C组和F组感觉阻滞的平均持续时间分别为253.3分钟和249.6分钟，差异无统计学意义（P = 0.76）。C组和F组运动阻滞的平均持续时间分别为302.3分钟和293.6分钟，差异也无统计学意义（P = 0.53）。C组和F组术后镇痛的平均持续时间分别为653.4分钟和611.2分钟，差异无统计学意义（P = 0.09）。10分钟后C组平均心率为82.5，F组为87.2，差异无统计学意义（P = 0.29），10分钟后C组平均动脉压为96.3mmHg，F组为97.3mmHg，差异也无统计学意义（P = 0.86）。
在蛛网膜下腔阻滞中，75μg可乐定和25μg芬太尼作为布比卡因的佐剂，在镇痛持续时间、运动阻滞持续时间和血流动力学稳定性方面具有相似的有益效果，并发症发生率也相当。
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