A PROSPECTIVE, DOUBLE BLIND RANDOMIZED CONTROLLED STUDY COMPARING THE EFFECTS OF MAGNESIUM SULPHATE VERSUS CLONIDINE AS AN ADJUNCT TO BUPIVICAINE IN SUB UMBILICAL SURGERIES

NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Sadhana Roy,
H. No. 17-1-391/S/581,
Near Vaidehi Ashram,
Singareni Colony,
Hyderabad-500059.
E-mail: drrajeevsinghthakur@yahoo.co.in

ABSTRACT: OBJECTIVE:  Providing comfort to the patient by prevention/relief of pain using various combinations of drugs thus achieving maximal benefit with minimal adverse effects is the ultimate goal of the anesthesiologist in the peri-operative period. AIM OF STUDY:  To evaluate the efficacy of Magnesium Sulphate Versus Clonidine as an adjunct to Bupivicaine in Epidural Analgesia. METHODS:  A total of 90 patients of either gender with ASA Grade (I, II), aged between 18 to 60 years scheduled for elective sub umbilical surgeries were randomly assigned in a prospective double blind study to three separate groups that received epidural 0.5% Bupivicaine (19ml) with 1ml of 0.9% Normal Saline or 0.5% Bupivicaine (19ml) with Magnesium sulphate 50mg (1ml) or 0.5% Bupivicaine With Clonidine 150 micro gram (1ml). All Patients were administered Pre-medication as per Hospital Protocol night before and morning of Surgery. Intra operative monitoring of patients included Heart-rate, ECG, SPO2, NIBP, RR as a Base Line and follow-up after Injection of assigned drug. Sensory blockade was evaluated by using bilateral pinprick method, motor blockade was estimated using modified Bromage scale at 5, 10, 15, 20, 25 and 30 Minutes Interval after Epidural Administration of drug. Pain perceived was assessed with Visual Analog Scale (VAS 0 - 10) both Intra Operatively and Post Operatively. In the event of pain with VAS >5, top-up of 0.5% Bupivicaine alone was added. The time from onset of blockade till need for 1st top-up was evaluated. CONCLUSION:  Co- administration of Magnesium Sulphate (50mg) to Epidural 0.5% Bupivicaine provides a predictable and rapid onset of nerve blockade without any side effects whereas co-administration of clonidine (150 micro-grams) to Epidural 0.5% Bupivacaine produced prolonged duration of anesthesia. The use of adjuvants in Epidural Aneasthesia gives a scope to improve the quality of anesthesia while minimizing the adverse effects.
KEYWORDS:  Bupivicaine, Clonidine, Duration, Epidural Anesthesia, Magnesium Sulphate, Onset.