A comparative study of epidural fentanyl and clonidine as an adjunct to bupivacaine in patients undergoing abdominal hysterectomy
Dr. K Rajarajeswaran, Dr. S Sivakumar
Aim and background: Epidural techniques are widely used for operative anaesthesia, postoperative pain control, with less physiological disturbances and side effects than spinal anaesthesia. Aim of this study is to compare epidural bupivacaine alone, with clonidine-bupivacaine and fentanyl-bupivacaine combination in patients undergoing abdominal hysterectomy in terms of duration of analgesia, the hemodynamic effects, side effects, onset of sensory and motor blockade.rnMethods and Materials: Ninety ASA I and II, female patients between 35-55 years, were randomly selected into three groups (Group I bupivacaine alone, group II bupivacaine with fentanyl and group III bupivacaine with clonidine in epidural). The onset of analgesia, onset of motor block, duration of analgesia and degree of sedation were noted in each group after performing epidural anesthesia. rnResults: The mean time of onset of analgesia were 15.97 ± 1.99 min, 11.83 ± 1.51 min, 11.90 ± 1.45 min in group I, II, III respectively. The mean time for total duration of analgesia were 207.33 ± 26.12 min, 369.66 ± 46.49 and 392.33 ± 46.95 in group I, II and III respectively.rnConclusion: Our study show that it is possible to significantly reduce the incidence of side effects (like nausea, vomiting, pruritus) caused by epidural fentanyl by replacing fentanyl with clonidine with the same safety and analgesic efficacy as epidural fentanyl when combined with a local anesthetic.