Abstract
THE ANALGESIC EFFICACY AND SAFETY OF EPIDURAL CLONIDINE FOR POST OPERATIVE ANALGESIA IN PATIENTS UNDERGOING LUMBOSACRAL SURGERY

Nahila Mahajan, Malik Zaffer Iqbal, Farooq Ahmad Ganie*, Vilayet Nabi Bucch, Imtiyaz A. Naqash

ABSTRACT

Aims: The aim of the study was to evaluate the efficacy of epidural clonidine for postoperative analgesia after lumbosacral surgery and to assess its safety and morphine sparing effect in postoperative period. Settings and Design: Prospective, randomized, double-blind study. Subjects and Methods: Seventy patients of ASA physical status I and II of either sex, in the age group 18-60 years undergoing lumbosacral surgery, were allocated to two groups of 35 patients each to receive epidural clonidine hydrochloride 1.5μg/kg in 5ml saline or normal saline the on arrival to PACU, followed by infusion of clonidine or normal saline, which was continued in the next 24 hours postoperatively. Postoperative hemodynamic parameters (systolic and diastolic arterial blood pressure and heart rate), pain scores using VAS, total morphine consumption and side effects (nausea, vomiting, sedation) were recorded and analysed statistically. Results: VAS over 24 hours were generally low in both the groups throughout the study, with the mean VAS score of 1.68±0.387 and 2.35±0.371 (p<0.001). The mean morphine consumption over 24 hours postoperatively was higher in group I than group II (1.54±0.864 mg versus 2.62±0.693 mg; p-value of 0.039. There were statistically significant differences in the postoperative hemodynamic parameters over 24 hours (p‹0.001).Only 3 patients (8.6%) in group I and 11 patients (31.4%) in group II had postoperative nausea and vomiting. There was no significant difference in sedation scores, demographic characteristics among the two groups. Conclusion: It can be concluded from our study that the epidural clonidine, as a sole analgesic agent, provides adequate analgesia in spine surgeries in terms of VAS score and overall patient satisfaction and it reduces the demand for intravenous morphine. It produces few side effects of its own.

Keywords: clonidine, spine surgery.


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