A STUDY OF CLONIDINE OF EPIDURAL ANAESTHESIA FOR LOWER LIMB ORTHOPEDIC SURGERIES
Vakati Chakravathy
Associate Professor, Department of Anesthesiology, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Kancheepuram District Tamilnadu, India 603319, India.
Prashanth A B
Assistant Professor, Department of Anesthesiology, RVS Institute of Medical Sciences, RVS Nagar, Chittoor, Andhra Pradesh 517127, India.
Neuraxial anesthesia is a term that denotes all forms of central blocks, involving the spinal, epidural, and caudal spaces. Epidural anesthesia is a versatile technique widely used in anesthetic practice. Its potential to decrease postoperative morbidity and mortality has been demonstrated by numerous studies. Regional anaesthesia has lot of advantages compared to general anaesthesia for lower limb surgeries. The advantages are patient is awake, multiple drugs not needed, no airway manipulation , good motor and sensory blockade, early food intake by the patient, less incidence of post-operative nausea, vomiting, prolonged postoperative analgesia, ideal operating conditions, reduces post-operative cardiac and pulomonary risk. In addition epidural anaesthesia produces powerful surgical anaesthesia and the length may be prolonged according to surgery, it presents extended postoperative analgesia, decreases the occurrence of hemodynamic modifications. In contrast to spinal anaesthesia, in epidural anaesthesia there is no occurrence of Post dural puncture headache as the dura isn't penetrated. Opioids remain the analgesic adjuvant of choice for augmenting the effects of local anesthetics in the epidural space. Epidural administration of fentanyl intraoperatively has been shown to significantly reduce volatile agent requirements by more than twofold in some instances. Despite the benefits of neuraxial opioids, side effects do occur. Some of the more common side effects are pruritus (specifically in the mid-facial area), nausea, and urinary retention .Another class of analgesic adjuvants includes alpha-adrenergic agonists. Clonidine is the main drug used in this class due to its production as a preservative-free preparation. In this study we compared the effects of epidural clonidine with dexmeditomidine in terms of prolongation of motor blockade.
8 , 2 , 2018
54 - 57