English

Abstract

BACKGROUND: Pre-emptive analgesia is a treatment that is initiated before the surgical procedure in order to reduce sensitization of central and peripheral pain pathways produced by pain signals evoked by tissue damage. Clonidine has demonstrated efficacy in clinical trials as pre-emptive analgesic in postoperative pain management. OBJECTIVE: The present study was conducted to evaluate postoperative analgesic benefit in patients administered clonidine or placebo for below umbilical surgeries to be performed under subarachnoid block (SAB) using 3ml 0.5%bupivacaine & to compare their postoperative efficacy with respect to duration of analgesia, 24hrs postoperative requirements of total analgesics and study side effects. MATERIAL & METHODS: Sixty patients of either sex (30 per group, 20-65yrs, ASA class I-II) received either oral placebo (group PC) or clonidine 150µg (group CL) one hr preoperatively. The postoperative Visual Analogue Scale (VAS) score was assessed for 24hrs every 2hrly. The patients were given iv Diclofenac75mg as rescue analgesic at VAS ≥4.The time at which patient demanded rescue analgesic for first time & total requirement of 24 hrs postoperative analgesics was noted. STATISTICAL ANALYSIS: Software used in the analysis was EPI info software (3.4.3). Data was reported as mean value ± SD, P-value of < 0.05 was considered statistically significant. Unpaired T - test was used to find out significance between two samples. The comparison of normally distributed continuous variables between the groups was performed by means of one-way analysis of variance (ANOVA) and, if appropriate, followed by Dunnett multiple comparison tests. Nominal categorical data among study groups were compared using the chi-square test. Results: Total duration of analgesia in Group-CL was significantly more than Group-PC. (492.66 ±78.29 min. Group-CL, 264.83 ±13.67 min. Group-PC, p=0.000), lower rescue analgesic requirement in Group-CL than in Group-PC (2.20 ±0.61 Group-CL, 4.03 ± 0.66 Group-PC, p=0.000). CONCLUSION: Pre-emptive oral clonidine appears to be effective in prolongation of postoperative analgesia with decreased rescue analgesic requirements. The main side effects observed were hypotension & bradycardia.