Comparison between epidural ropivacaine and ropivacaine–clonidine combination for infraumbilical surgeries: A randomized clinical study

Abstract

Introduction: Lower abdominal and lower limb surgeries may be performed under local, regional (spinal or epidural) or general anaesthesia, but neuraxial blockade is preferred mode of anaesthesia. Major advantage of epidural anaesthesia over spinal anaesthesia is the ability to titrate the extent and duration of anaesthesia. Aims and Objective: The primary outcome of the study was to measure the duration of sensory analgesia. The secondary outcomes were onset of sensory block, onset of motor block, highest level of sensory block, degree of motor block, duration of motor block, and quality of sensory blockage as measured by visual analog scale. Material and Methods: After getting institutional ethical clearance from our institute and proper written consent from each patient a total of 80 patients who underwent infraumbilical surgeries. A total of 80 patients who underwent infraumbilical surgeries were included randomly into two clinical study groups comprising 40 patients in each study group. Epidural anaesthesia was administered with 20ml of Ropivacaine 0.75% (GROUP-R) and 20 ml of epidural Ropivacaine 0.75% and Clonidine 75mcg combination (GROUP-RC). Statistical Analysis: Statistical comparison was made by comparison between groups by applying chi-square test to a contingency table for categorical data and two sample t–test and independent t-test for numerical data. Result: A total of 102 patients were assessed for eligibility, of which 16 patients did not meet the inclusion criteria and 6 patients were excluded during the study period. The groups was comparable with regard to demographic data and incidences of side effects except for the higher incidence of dry mouth in patients of RC group. Onset of analgesia was much shorter in RC group with prolonged duration of analgesia. The incidence of bradycardia and hypotension was more in RC group as compared to R group which was statistically significant. Conclusion: The addition of 75mcg clonidine to isobaric epidural ropivacaine results in longer, complete and effective analgesia with similar block properties and helped to reduce the effective dose of ropivacaine when compared with plain ropivacaine for infraumbilical surgery