B Kanchanamala

Abstract

Background: Ambulatory surgery has become popular in this era which has resulted in the advent of newer short acting anaesthetic drugs to suit early ambulation of post operative patients and discharge and early resumption of daily activities. This in turn reduces cost of care, increased availability of beds for sick patients, lower risk of resistant bacterial strain transmission and faster return to work and social activities., This study was aimed to find out the effective low dose of 1% chloroprocaine for lower limb ambulatory surgeries performed as day care procedures. Materials and Methods: 93 consented patients were randomized to three groups of 31 each to receive 20 mg, 25 mg and 30mg of 1%chloroprocineintrathecally. Sensory and motor block was assessed. Statistical Analysis: The collected data was analysed using IBM.SPSS statistics23.0 Version. Results: The demographic data in all three groups were comparable. The onset of motor blockade was profound in patients receiving 30 mg of chloroprocaine compared to 20 or 25 mg. The blook persisted for longer duration with delayed voiding of urine, delay in unassisted ambulation inpatients receiving 30 mg of 1% chloroprocaine.   Keywords: 1% chloroprocaine, Ambulatory anaesthesia, Spinal anaesthesia.

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Abstract

Introduction: Epidural labour analgesia is considered as the gold standard of pain relief for paturients inspite of the hesitancy that is prevalent in our country in providing pain-free labour.  There are several other pharmacological and non pharmacological methods available for providing labour analgesia. Local anaesthetic is an indispensable drug for administering epidural labour analgesia Ropivacaine is the most widely used local anaesthetic for labour analgesia because of its safety profile proven by various studies. It is less potent and onset of action is slightly prolonged when compared to bupivacaine or levobupivacaine. Use of adjuvants along with local anaesthetic reduces the total dose of local anaesthetic that is required for providing effective labour analgesia. Clonidine is a centrally acting partial alpha 2 adrenergic agonist that reduces the anaesthetic and analgesic requirement of local anaesthetic. This study is aimed to study the effect of ropivacaine with clonidine as an adjuvant for labour analgesia. Objective: To compare the time of onset of analgesia, total dose of local anaesthetic required, total duration of analgesia and neonatal outcome between the two groups, Group I with ropivacaine and Group II ropivacaine with clonidine. Materials and Methods: A prospective randomised controlled study was conducted in a government peripheral medical College after getting ethical committee clearance 100 patrurients randomised  into two groups, Group I received 2% ropivacaine and Group II received 2% ropivacaine with 40 micrograms of clonidine. Statistical Analysis: The results were analysed with SPSSVersion 13 using student t - test and chi square test Results: The mean age was 23.4  ±1.7 years. The mean onset time of Group A and Group B were 12.9±1.3 minutes and 17.7±1.3 minutes with p Conclusion: Addition of 40 micrograms of clonidine with Ropivacaine epidurally resulted in rapid onset of analgesia with required dose of Ropivacaine. Use of Clonidine as adjuvant didn't produce any undesirable motor blockade or neonatal depression.   Keywords: Ropivacaine, Epidural labour analgesia, Clonidine.

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