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Effect of clonidine on bupivacaine andlevobupivacaine in postoperative epidural analgesia afterorthopedic surgery in lower limbs

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Anesthesiology

Advisors

Manssour, Amr Z., Yousuf, Muhammad F., Fadhel, Nasser

Authors

El-Gendi, Wael Husni

Accessioned

2017-04-26 12:05:11

Available

2017-04-26 12:05:11

type

M.D. Thesis

Abstract

The effective relief of pain is of paramount importance to anyoneundergoing surgery. This should be achieved for humanitarian reasons;smoother postoperative course with earlier discharge from the hospital,preventing what is caused by pain like increase in sympathetic responseof the body with subsequent rises in heart rate, cardiac work, and oxygenconsumption. Also, it decreases the risk of deep venous thrombosis andsubsequent pulmonary embolism, ilieus, nausea, vomiting, and urinaryretention.We studied the effect of addition of clonidine to bupivacaine andLevobupivacaine in postoperative epidural analgesia after orthopedicsurgery in lower limbs aiming to get good analgesia, less motor effect oflevobupivacaine, and cost benefit by adding clonidine to the localanesthetics.This study was carried out on 96 patients undergoing lower limbsurgeries in a double blind manner, divided into four groups. By the bolusmethod, the first group received bupivacaine 0.25%, second one receivedlevobupivacaine 0.25%, third one received bupivacaine 0.125%+clonidine , and the fourth one received levobupivacaine 0.125%+clonidine.We assessed pain by visual analogue scale, motor power by modifiedBromage scale, sedation by Ramsay sedation scale, the hemodynamicfunction (heart rate, systolic, diastolic, and mean blood pressures), andrespiratory function ( respiratory rate, and Oxygen saturation).In tis study, we concluded that, as regard potency and duration lumbarepidural levobupivacaine is similar to bupivacaine, and levobupivacaine with clonidine are similar to bupivacaine with clonidine. As regard motorpower affection, levobupivacaine is similar to bupivacaine, andlevobupivacaine with clonidine are similar to bupivacaine with clonidineand are less than the first two groups. Economically, levobupivacaine isstill much expensive than bupivacaine . So, in the present study when wewanted to arrange the groups, we found the group of bupivacaine plusclonidine is the best, then bupivacaine, then levobupivacaine plus clonidine, then levobupivacaine.

Issued

1 Jan 2007

DOI

http://dx.doi.org/10.21473/iknito-space/32067

Details

Type

Thesis

Created At

31 Jan 2023