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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Comparison of Morphine and Clonidine as Adjuncts to Bupivacaine in Spinal Anaesthesia- A Double Blind Randomised Control Trial
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Comparison of Morphine and Clonidine as Adjuncts to Bupivacaine in Spinal Anaesthesia- A Double Blind Randomised Control Trial

机译：吗啡和Clonidine与Bupivacaine在脊柱麻痹中的辅助比较 - 双盲随机对照试验

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Spinal anaesthesia is a preferred choice for infraumbilical surgery. Various drugs have been added intrathecally to augment analgesia in the postoperative period. Morphine an opiate was among the first to be introduced. More recently the alpha-2 agonist Clonidine.Aim: To compare Clonidine and Morphine as adjuncts to bupivacaine in spinal anaesthesia on the quality of the block, the duration of postoperative analgesia, haemodynamic changes and complication.Materials and Methods: In this randomised double blind controlled study, one hundred patients between age 20-40 years of age and American Society of Anaesthesiologists (ASA) physical status 1 and 2 undergoing lower limb Orthopaedic procedures were studied to compare the effect of preservative free morphine (100 mcg) (Group BM) and clonidine (30 mcg) (Group BC) as an adjunct to 0.5% bupivacaine in spinal anaesthesia. Group BM received a mixture of 2.6 mL (13 mg) of hyperbaric bupivacaine (0.5%) with 0.1 mL of preservative free Morphine and 0.1 mL 0.9% saline. Group BC received a mixture of 2.6 mL (13 mg) of hyperbaric bupivacaine (0.5%) with 0.2 mL of clonidine (30 mcg).Total volume of solution in both the groups was 2.8 mL. The groups were compared for the onset and duration of sensory and motor blockade. Duration of analgesia, Sedation, Haemodynamic variations viz., Pulse rate, blood pressure and Complications. Data obtained was analysed using Student t-test, Pearson chi-square test and ANOVA as appropriate.Results: Onset of sensory block was faster and duration of the sensory as well as motor block was more after addition of Clonidine (30 μg) to bupivacaine in spinal anaesthesia. The duration of postoperative analgesia was significantly prolonged to 10-13 hours in patients receiving Bupivacaine and morphine combination as compared to 6-8 hours noted in patients receiving Bupivacaine and Clonidine only. Incidence of hypotension, bradycardia, shivering, nausea and vomiting was not statistically significant. None of the patients in both groups showed any other side effects like respiratory depression, hypoxia, excessive sedation or any other spinal consequences.Conclusion: Clonidine improves the quality of spinal anaesthesia in terms of faster onset of sensory block and longer duration of sensory as well as motor block compared to morphine, when added as an adjunct. However, the duration of postoperative analgesia was prolonged more with the addition of Morphine compared to Clonidine.
机译：脊髓麻醉是非造盲手术的首选。在术后期间，各种药物已在术后期间增强镇痛。 Mulphine Apiate是第一次被介绍的。最近更近于α-2激动剂Clonidine。目的：将Clonidine和吗啡与Bupivacaine在脊髓麻醉上的副作用上的助剂，术后镇痛的持续时间，血液动力学变化和并发症。材料和方法：在这项随机双盲对照研究中，研究了20-40岁和美国麻醉学士学院（ASA）身体状态1和2的患者患者身体状况1和2的患者进行了研究，以比较防腐剂吗啡的影响（100 MCG）（BM组）和Clonidine（30mcg）（BC组）作为脊髓麻醉中0.5％Bupivaine的辅助。组BM接收2.6ml（13mg）的高压布酸（0.5％）的混合物，其具有0.1ml防腐剂和0.1ml 0.9％盐水。 BC群接受2.6ml（13mg）的高压布酸（0.5％）的混合物，其中0.2ml Clonidine（30mcg）。两组中溶液的溶液体积为2.8mL。将这些组进行比较，以便感觉和电机阻滞的发作和持续时间。镇痛持续时间，镇静，血液动力学变异viz，脉率，血压和并发症。使用学生T检验，Pearson Chi-Square测试和Anova进行分析所获得的数据。结果：感觉块的发作速度更快，感觉持续时间以及电动机块在加入克拿尼量后更多（30μg ）在脊柱麻醉中的布比卡因。术后镇痛的持续时间在接受Bupivacaine和Metphine组合的患者中显着延长至10-13小时，而仅接受Bupivacaine和Clonidine的患者6-8小时。低血压，心动过缓，颤抖，恶心和呕吐的发病率并不统计学意义。两组患者均未表现出任何其他副作用，如呼吸抑制，缺氧，过度镇静或任何其他脊柱后果。结论：CLONIDINE在感觉块的更快发作和更长的时间内提高了脊髓麻醉的质量与吗啡相比，感觉以及电机块，当添加为辅助时。然而，与Clonidine相比，术后镇痛的持续时间延长了吗啡。

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