A Comparative Study of Qualitative Analgesia for Postoperative Period between Ropivacaine and Ropivacaine with Clonidine in Epidural Block

Background: Pain is one of the most emotional sensation known to mankind. It frequently exceeds its protective nature and makes postoperative period a suffering. The pain in the postoperative period demands relief not only on humanitarian ground but also to reduce physical morbidity following the operation. So relief of pain in postoperative period extends the anaesthesiologists interest beyond the confines of the operating theatre. Epidural anaesthetic and analgesic techniques are commonly used for various operative procedures, obstetric analgesia, postoperative pain and chronic pain management. Ropivacaine has increasingly replaced bupivacaine because of its similar analgesic properties, lesser motor blockade and decreased propensity of cardiotoxicity. Clonidine has been frequently used as an adjunct to local anesthetics because it improves the quality of anesthesia and analgesia, reduces the dose requirement of the anesthetic agent and provides a more stable cardiovascular course. In this study we included 60 patients undergoing various endoscopic urological surgeries like TURP, URS, OIU and cystoscopy procedures. Material and Methods: Patients were randomly divided in two groups. R-Group: 30 patients received 0.5% ropivacaine 18 ml. RC-Group: 30 patients received 0.5% ropivacaine 18 ml with clonidine 60 μg . Pre-op and intra-op, haemodynamic parameters and side effects were observed. For postoperative pain assessment, VAS score was used at postoperative 2,4,6,7,8,9,10,12 hour. Results: The objective evidence of block like mean arterial pressure, heart rate showed significant change in RC-group. Pain score(VAS) was significant at 6 th hr ,7 th hr ,8 th hr ,9 th hr and at 10 th hr postoperative period due to the reduced VAS in RC-Group. Demand of rescue analgesia was more in R-Group. Level of sedation, side effects were not statistically significant. Conclusion: Clonidine as an adjunct to Ropivacaine by epidural injection improves and augments the block, reduces heart rate and blood pressure. It also prolongs the duration and the quality of analgesia in postoperative period with no more side effects like nausea, vomiting and sedation.