Online ISSN: 2515-8260

Keywords : Clonidine

To Compare The Perioperative Benefits Of Oral Midazolam And Oral Clonidine In Patients Undergoing Major Abdominal Surgeries Under General Anaesthesia

Dipty Agrawal, Jugal Kishor Agarwal, Aijaz Ahmad, Vinay Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1650-1658

Background: One of the challenges for anaesthesiologists is to minimize distress for patients in the operating room (OR) environment and to facilitate a smooth induction of anesthesia.A sedative drug is given before transfer to the OR. The beneficial effects of anxiolytic are sedation, anxiolysis, reduction of postoperative vomiting andpostoperative emergence phenomenon. Clonidine, an α 2-agonist, have been suggested as another option for premedication as effective as midazolam.
Materials and Methods: 50 patients were randomly divided into two groups.To one group Tab. Midazolam 7.5 mg was given while to other group Tab. Clonidine 100 µg was given one hour before induction ofanesthesia.Patients were evaluated and compared for benefits of preoperative oral midazolam and oral clonidine on sedation scores, perioperative hemodynamic parameters and perioperative opioid and analgesic requirement. Independent sample t-test was used and p-value < 0.05 was considered significant.
Results: We found that mean OAA/S sedation score in clonidine group was 11.48 ± 1.12 than in midazolam group13.68 ±1.03withsignificant difference ofp value (p<0.001).There was significant (P < 0.05) attenuation of hemodynamic response to intubation, surgical stress response and extubation with clonidine as compared to midazolam .None of the patients desaturatedin either group. Opioid requirement(72%)was more in midazolam group as compared to clonidine (28%)group. Recovery in clonidine group took slightly longer time 60.00 ± 13.77min as compared to midazolam group 44.40±13.25 min.
Conclusion: Premedication with 100 micrograms of oral clonidine can reasonably be recommended as premedication in ASA I and II patients for all surgeries to provide more sedation, stable hemodynamics intraoperatively, reduction in stress response,less opioid consumption.

To evaluate the effect of local infiltration of Ropivacaine 0.75 % and clonidine in post operative pain management of total knee arthroplasty

Dr. Amit Gavali, Dr. Hemant S Dambale, Dr. Nitin D Waghchoure, Dr. Shrikant M Upasani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2804-2808

Introduction: Pain is constant companion for human. There is perhaps nothing as dreaded as pain. Pain is the ultimate teacher. It alerts the body to disease. Depending upon the intensity and duration, it impacts quality of life. Pain after total knee arthroplasty (TKA) is a big concern in orthopaedics. Although opioids and continuous epidural analgesia remains the major option for the postoperative pain management of TKA, they have undesirable side effects like sedation, nausea and hypotension.  Epidural catheterization is skilful and technically demanding procedure with close monitoring. Infiltration of local anesthetic solution minimizes pain at the source superiorly. It has short learning curve, no systemic side effects, no infection, level of motor block is none, early mobilization and cost effective. There is not much study done on combination of Ropivacaine and Clonidine as a LIA.
Material and Methods: A prospective study was carried out among 30 cases undergoing total knee surgery at a tertiary care hospital. During pre-anaesthetic check up detailed assessment of airway, respiratory and cardiovascular system was carried out. Basic laboratory data were reviewed. Informed consent was taken. All patients were kept nil per oral for 8 hours and were pre-medicated with Tab Ranitidine 150mg, Tab Diazepam 5mg orally 12 hours before surgery. Patients were taught the visual analog pain scale (VAS) (0 = no pain, 10 = worst imaginable pain), and VAS was measured preoperatively at rest and on movement of the knee to be operated.
Results: We observed that; mean age was 62.7+9.9 years. Out of 30, 70% were female and 30% were males. Pain control with Ropivacaine and clonidine has been very effective in 1st 24 hours in total knee replacement surgery.
Conclusion: From this study s we concluded that, with the use of local infiltrative anesthesia i.e combination of Ropivacaine & clonidine, requirement of opioid has been decreased. Effects on cardiovascular system like tachycardia, hypertension has also been decreased. It also benefited patient by early mobilization.

Comparison of Analgesic Effect of Fentanyl and Clonidine Added Intrathecally with Bupivacaine in LSCS

Firasath, Abhinaya, Raja Shekar Reddy Motkar, Khaja Layeeq Ur Rahman

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 6094-6103

Background:Hyperbaric bupivacaine 0.5% (l0mg) with fentanyl 15mcg(0.3ml) and (2)
Hyperbaric bupivacaine 0.5% (10mg) with clonidine 45mcg. Objectives: The study
compared the onset and duration of action of intrathecal hyperbaric bupivacaine 0.5
percent and fentanyl 15mcg (group-I) to intrathecal hyperbaric bupivacaine 0.5 percent
and clonidine 45 mcg (group-II) in spinal anaesthesia in LSCS. The combination of
bupivacaine with fentanyl or clonidine assists anesthesiologists in alleviating
intraoperative discomfort by delivering superior analgesia to patients without extending
Materials and Methods: The study included 80 female patients with ASA grade I (n=40
in each group). The time of onset of sensory and motor block, duration of analgesia, 2-
segment regression, intraoperative discomfort, hemodynamic stability, time to
micturition, visual analogue score, and postoperative analgesic requirements were all
Results: In group II, the onset of sensory and motor block was substantially later than
in group I (p0.001). Hemodynamic alterations did not differ between groups (p>0.05).
Intraoperatively, 1 patient reported pruritis, and 2 patients had postoperative urinary
II78.506.12min and groupII-—121.284.09 min) and regression of sensory level to L2
dermatome (group-I - 142.206.73 min and group II 166.405.79 min) were significantly
longer in group II (p0.001). The duration of analgesia in group II was 210.186.79
minutes, whereas in group II it was 323.5610.53 minutes, which is significant (p0.001).
The VAS scores in group II were considerably lower after 3 hours (p0.05), 6 hours
(p0.001), and 12hours (p0.001).
Conclusion: The addition of intrathecal clonidine 45 mcg to hyperbaric bupivacaine in
spinal anaesthesia gives greater analgesia with less perioperative discomfort, a longer
duration of analgesia, and a reduction in postoperative analgesic requirements.

A randomized double blind comparative study of the effects of fentanyl and clonidine as additives to intrathecal hyperbaric bupivacaine for spinal anaesthesia

Dr T Tejaswini, Dr Muthavarapu. P.K. Teja, Dr Natra Sarala

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10257-10266

Aim: To compare the effects of fentanyl 25microgram and clonidine 30 microgram as
additives to 3 ml of 0.5 % hyperbaric bupivacaine for spinal anaesthesia in lower
extremity orthopedic and urological surgeries.
Materials and methods: This prospective, randomized, double blind study was
conducted on 60 adult patients of ASA physical status 1 & 2 in the age group of 20 years
to 60 years, posted for elective lower limb and urological surgeries under spinal
anaesthesia. Patients belonging to group BF received 3 ml (15 mg) of hyperbaric
bupivacaine (0.5 %) + 0.5 ml (25 microgram) fentanyl. Patients of group B received 3
ml (15 mg) of hyperbaric bupivacaine (0.5 + 0.2 ml (30 microgram) clonidine + 0.3 ml of
normal saline. The following parameters were observed - onset and duration of sensory
block, onset and duration of motor block, durations of complete and effective analgesia
and any side effects associated with these drugs.
Results: The present study showed that the duration of sensory and motor block was
prolonged with the addition of 30 microgram clonidine to intrathecal hyperbaric
bupivacaine as compared to 25 micrograms of fentanyl, same as the duration of
complete and effective analgesia. Both groups were comparable in hemodynamic
stability and there were no significant adverse effects.
Conclusion: Compared to fentanyl 25 microgram, clonidine 30 microgram as additive to
intrathecal hyperbaric bupivacaine for spinal anaesthesia, prolonged the duration of
complete and effective analgesia, which was statistically significant

Comparison of Hyperbaric Bupivacaine Alone and Combination of Hyperbaric Bupivacaine with Clonidine in Cesarean Section: A Prospective Randomized Clinical Trial

Aman Malawat, Sudhir Sachdev, Sakshi Kanoji, Mangilal Deganwa, Durga Jethava

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10480-10489

Introduction: Spinal anaesthesia using hyperbaric bupivacaine with adjuvants such as
clonidine is now the routine and preferred technique for majority of the surgical cases.
Aim: to compare various block characteristics alongwith materno-fetal outcome in
patients scheduled for caesarean section under subarachnoid block (SAB), following
administration of hyperbaric bupivacaine alone and in combination with clonidine
Methods: In this randomized clinical trial, 90 patients undergoing elective cesarean
section were randomly allocated to two groups. The patients of Group A received
intrathecal 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of normal saline and Group
B received intrathecal 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of clonidine (30
μg). Various block characteristics and materno-fetal outcome were compared between
the groups.
Results: Group B had quicker sensory onset (3.17 ± 1.05 min vs. 3.50 ± 0.94 min), longer
duration of sensory and motor block (209.73 ± 30.70 min and 147.50 ± 23.00 min),
longer time for rescue analgesia demand (298.83 ± 44.68 min) in comparison to Group
Conclusion: Intrathecal clonidine provided better block characteristics and outcome
measures in terms of prolonged sensory as well as motor blockade, longer duration of
analgesia, greater intraoperative relaxation and minimal or no adverse incidences.

Efficacy of preanesthetic single dose intravenous dexmedetomidine versus intravenous clonidine in patient undergoing elective surgery under general anesthesia: Changes in blood pressure

Dr. Nagendra Prasad, Dr. Shivakumar, Dr. Nandini

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2451-2455

Surgeries involving general anaesthesia where airway manipulation occurred during laryngoscopy and endotracheal intubation produces stimulation of epipha1ynx and laryngopharynx giving rise to hae1nodynatnic alteration due to catecholamine surge or response. Haemodynamic changes are accentuated in high risk cardiac patient. After obtaining approval from the institutional ethical committee patients fulfilling the inclusion/exclusion criteria were included in the study after obtaining informed consent. A preanesthetic evaluation of history of surgical and medical illness, drug allergies previous anaesthetic exposure and Baseline investigations of blood, ECG, radiograph of chest and airway examination was done. Patient was kept nil by mouth for at least 8hrs prior to surgery. All patients were premedicated with injection Pantoprazole 40mg (IV) one hour prior to surgery. Preoperative vital parameters like baseline pulse, blood pressure were noted. Systolic blood pressure in significantly lower in Group D patient after 40 minutes of intubation continues to be low at 6th, 8th, 10th, 15th and 20th minutes compared to Group C.

Preanesthetic single dose intravenous dexmedetomidine versus intravenous for blunting of sympathetic response to laryngoscopy and endotracheal intubation: Clinical profile of patients

Dr. Nagendra Prasad, Dr. Shivakumar, Dr. Nandini

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2441-2445

The sensory unit consists of free nerve endings that lie between the mucosal cells of the airway epithelium. Sensory units appear to be particularly abundant over the arytenoid cartilages and are also found on the laryngeal side of the epiglottis. Study was undertaken in patients planned for elective surgeries under General Anaesthesia. Patient were selected between 18 to 60yrs of Age with ASA 1 and ASA 2 grades. They were divided into 2 groups of 30 each and allocated randomly. All patients were explained about the procedure and its complication and informed consent obtained. There were no significant differences between the two groups with regard to demographic data such as age and weight. The average age in Group-C (clonidine) was 31.90 years and average age in Group D (dexmedetomidine) was 34.80 years.


Dr Rajveer Basu, Dr Jugvendra Lahari, Kiran Lahari, Dr Preeti Lahari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1941-1947

Background:Decreasing MAP (mean arterial blood pressure) using controlled hypotension, is introduced to improve visibility of the surgical site by reducing blood loss during FESS.
Aims:The present study was conducted to compare and assess the hemodynamic stability and hypotensive efficacy of Clonidine and Dexmedetomidine in FESS.
Materials and Methods:40 subjects were randomly divided into two groups of 20 subjects each. Subjects from Group I received 1 μg/kg dexmedetomidine, whereas, Group II subjects received 2 μg/kg Clonidine. Postoperative complications and Haemodynamic parameters were assessed at baseline, following the loading dose, 1- and 5-minutes following intubation, and every 10 minutes till recovery. These parameters were mean arterial pressure, systolic and diastolic blood pressures, oxygen saturation, and heart rate (HR).
Results:MAP and HR decreased significantly from baseline at all the time intervals of assessment (p<0.001). These values were statistically significant for both intragroup and intergroup for Group I and Group II. Also, statistically non-significant results were seen concerning the visibility of the surgical field. Emergence time was significantly higher for Group I (7.38±0.58 min) than Group II (6.44±0.72 min) with p=0.001. Sedation scores were higher significantly for group I (1.88±1.23) than Group II (1.37±0.12) with p=0.001. VAS scores were significantly lower for Group I (2.24±0.78) than Group II (3.01±0.14) at all time intervals with p=0.001. First rescue analgesia was significantly higher for Group I (110.45±12.25 min) than Group II (84.31±10.06) with the p-value of <0.0001
Conclusion:Present study concludes that, better hemodynamic stability was seen with dexmedetomidine compared to Clonidine. However, decreased blood loss and intraoperative visibility were comparable for both dexmedetomidine and Clonidine. Sedation and prolonged anesthesia were also better with dexmedetomidine.

To study the effects of low dose oral clonidine premedication in attenuating the haemodynamic response to laryngoscopy and intubation

Dr.Pavankumar P, Dr.Venugopal K, Dr.Vinuth K Murthy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2850-2857

Background: The induction of anesthesia, laryngoscopy, tracheal intubation and surgical
stimulation often evoke cardiovascular responses characterized by alteration in systemic
arterial blood pressure, heart rate and cardiac rhythm
Aim: Efficacy of low dose of clonidine in attenuating the haemodynamic response to
intubation. Comparing two doses of oral clonidine in attenuating haemodynamic response to
Materials and Methods: The study will be conducted on 60 patients who will be undergoing
elective surgery under general anesthesia during the period of 2017 to 2019.
Group CL-1 and Group CL-2 patients were premeditated with oral Clonidine 60 minutes
prior to the surgery.
Randomisation: All the patients included in the study were randomized into 3 groups,
Group CL-1: Patients who received oral Clonidine premedication at the dose of 1 microgram
per kg.
Group CL-2: Patients who received clonidine premedication at the dose of 2microgram per
Group CS: Patients who received premedication with oral saline.
After shifting the patient inside the operating room noninvasive blood pressure, saturation
probe and electrocardiogram monitoring with 5 leads were attached and baseline values were
Duration of laryngoscopy and intubation (from the time laryngoscope inserted till the end
tidal CO2 is seen on the monitor) was noted, grade of laryngoscopy, heart rate, systolic
diastolic and mean blood pressures are noted at the time of induction, just before
laryngoscopy, immediately after intubation and 1,3 and 5mins after intubation by investigator
Results: In the present study when we evaluated the heart rate,SBP,DBP,MAP. There was
least variation HR, SBP, DBP and MAP, in those who received 2 mg clonidine as those who
received 1 mg clonidine as compared to the placebo saline group