To Compare the Side Effect of Dexmedetomidine and Clonidine as an Adjuvant to Intrathecal Bupivacaine in Patients Undergoing Total Abdominal Hysterectomy

Dr. Rupesh Choudhary, Dr. Rahul Sharma, Dr. Ankita Jamwal, Dr. Divya Drishti
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Abstract

Background: Addition of adjuvants to routinely used intrathecal drugs is cornerstone in safe and effective prolongation of single shot spinal block for gynecological surgery. In resource deficient countries, where epidural anaesthesia is usually not used because of cost factor, adjuvants are routinely used to prolong the effect of regional anaesthesia. Alpha 2 agonists are considered best drugs as adjuvants, but there is inconclusive data in literature about the block characteristic, dose at which to be used and side effect after use of these drugs. Methods: A prospective randomized single blind study was conducted in the Department of Anaesthesia IGMC SHIMLA at Kamla Nehru state hospital. Results: Hypotension was seen in 5 patients of Group C and 4 patients of Group D. Three patients in both the groups required 2 doses of Inj mephenteramine and 2 patients in Group C and 1 in Group D required single dose of Vasopressor (Inj mephentermine). (p=0.83). Five patients had bradycardia, 3 Nausea and 3 had shivering in Group C, while only 2 patients had side effects in Group D i.e one patient had bradycardia and another nausea, vomiting. (p= 0.657) Conclusion: We observed hypotension, bradycardia, nausea vomiting and post operative shivering in our patients during the study period but there was no statistical significance achieved amongst the groups. (p>0.05). 
目的比较右美托咪定与克拉定在全腹子宫切除术患者鞘内辅助布比卡因的副作用
背景:在常规鞘内药物的基础上添加辅助剂是安全有效延长妇科手术单针脊髓阻滞的基础。在资源缺乏的国家,由于成本因素通常不使用硬膜外麻醉,通常使用辅助剂来延长区域麻醉的效果。α - 2激动剂被认为是最好的佐剂,但文献中关于阻滞特性、使用剂量和使用后副作用的数据尚无定论。方法:在Kamla Nehru国立医院IGMC SHIMLA麻醉科进行前瞻性随机单盲研究。结果:C组5例、D组4例患者出现低血压,两组均有3例患者需要2剂量注射甲非那明,C组2例、D组1例患者需要单剂量注射甲非那明。(p = 0.83)。C组有5例心动过缓,3例恶心,3例寒战,而D组只有2例出现副作用,即1例心动过缓,1例恶心,呕吐。(p= 0.657)结论:研究期间患者出现低血压、心动过缓、恶心呕吐、术后寒战,但组间差异无统计学意义。(p > 0.05)。
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