Comparison of Dexmedetomidine or clonidine as adjuvant to Preemptive Thoracic Epidural Ropivacaine analgesia with propofol based TIVA in fast-track thoracic anaesthesia for open thoracic surgeries
DOI:
https://doi.org/10.48165/ijabms.2021.23111Keywords:
Preemptive Thoracic epidural Ropivacaine, Dexmedetomidine, Clonidine, TIVA, One lungAnaesthesia, Open thoracic surgeryAbstract
BACKGROUND: –Thoracic surgeries are very painful, I which require adequate anaesthesia& analgesia to modulate physiological responses of pain. In present study pre-emptive use of placebo/Dexmedetomidine / clonidine with Ropivacaine based perioperative thoracic epidural analgesia.AIM & OBJECTIVES: –To use both Alpha agonists with Ropivacaine for perioperative epidural analgesia with TIVA by propofol assessment of perioperative oxygenation, awareness, total dose of propofol, fast-tracking criteria were measured.STUDY DESIGN:A randomised retrospective observational studyMETHODS:In present study 75 adult patients of ASA grade, I/II of various elective thoracic surgeries in department of cardiothoracic & vascular surgery at V.S General hospital, NHLM Medical College, Ahmedabad, Gujarat.OBSERVATIONS AND RESULTS: -Both Alpha agonists with Ropivacaine provide good RESULTS: – bolus propofol & fentanyl required to maintain BIS in comparison to Ropivacaine alone.Fast-tracking criteria were comparable & good in each Group.CONCLUSION-Thoracic epidural analgesia with Ropivacaine definitely improved recovery, & provide good Fast-tracking criteria. Thoracic epidural Dexmedetomidine or clonidine with Ropivacaine provides better perioperative analgesia and improve Postoperative analgesia than Ropivacaine alone.
References
white PE (1999) Criteria for Fast-tracking outpatients after ambulatory surgery Journal of Clinical Anaesthesia,11:78-79.
Bong CL, Sanyal M, Mg JM, Effects of preemptive epidural analgesia on postthorcotomy pain journal of Cardiothoracic & vascular Anaesthesia.2005;19(6):786-793.
YeginA, ErdoganA, Kayaean N, Early postoperative pain management after thoracic surgery, preoperative and post-operative versus postoperative epidural analgesia, randomised study European journal of Cardiothoracic surgery 2003;24(3): 420-424.
Amr YM, Yousef AAA, Alzeftawy AE, Effects of preincisional epidural fentanyl & Bupivacaine on postoperative pain & pulmonary function. Annals of thoracic surgery 2010; 89(2):381-385.
Obata H, SaitoS, Fujita N, Epidural Analgesia with Mepivacaine before surgery and long-term postoperative pain. canadian Journal of Anaesthesia 1999; 46(12),1127-1132.
Senturkterm Postoperative thoracotomy pain. Anaesthesia & Analgesia 2002;94(1):11 M, OZcam PE, Talu GK, effects of 3 different techniques on long15.
Ochrach E thoracic A, Gottschalk A, longterm pain and activities during recovery from major thoracotomy using epidural analgesia. Anaesthesiology 2002;97(5)12341244.
Neustein SM, Kreitzer JM, preemptive thoracic epidural analgesia for thoracic surgery, Mount Si Medicine 2002,69(12):101104.
Yujun XU, Zimiing TM, Effects of thoracic epidural nai Journal of analgesia with different doses of Ropivacaine on arterial oxygenation during one lung ventilation. Anaesthesiology 5,2010, vol 112 ,1146
Prachi Kar, Padmaja Durga, Ramachandran Gopinath. Effects of Epidural Dexmedetomidine on oxygenation & shunt fraction during open thoracic surgery and one lung journal of Anaesthesia & clinical pharmacology. Nov 2016, volume 32, issue 4, page 458464.
chandak Amit, Kapdi Manisha, Comparison of Dexmedetomidine or Clonidine as adjuvant to intrathecal hyperbaric bupivacaïne for lower abdominal & lower limb surgeries Indian journal of Applied Basic medical Sciences, January 2015, issue 17a, page 3212. 40.
Kapdi MS, Desai Shruti, comparision of Dexmedetomidine or Clonidine as adjuvant to LA in US guided Supraclavi cular bracheal plexus block. Indian Journal of Anaesthesia & Analgesia. August 2018:5(8) Conflict of Interest: Nil Funding: Nil13501353.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Shivangi Patel, Manisha S. Kapdi
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.