A Randomised, Double Blinded Study on Comparison of Intrathecal Morphine and Clonidine as Adjuvant for Post-caesarean AnalgesiaCorrespondence Address :
Coochbehar Government Medical College and Hospital, Coochbehar, West Bengal, India.
Introduction: Caesarean section is a common obstetric operation which requires adequate and safe postoperative analgesia sometimes using morphine or clonidine to provide comfort to the mother and ease in handling the new born.
Aim: To compare the adjuvant effect of morphine and clonidine when co-administered intrathecally with 0.5% bupivacaine heavy during caesarean section.
Materials and Methods: A randomised double-blinded study was conducted on 90 parturient were randomly divided into three groups, during March to November 2011, receiving intrathecal 100 mcg morphine, 75 mcg clonidine and 0.5 mL normal saline along with 2.5 mL of 0.5% bupivacaine respectively. The quality and duration of postoperative analgesia and any side effects were assessed at fixed time interval. APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score of foetus was also done to assess their wellbeing. Statistical analysis was done using Analysis of Variance (for continuous variables like Blood Pressure, heart rate, etc.,) and chi-square test (for discrete variables like VAS score, side effects, etc.,).
Results: Postoperative VAS score at different time were much lower in the morphine group as compared to clonidine group (p-value<0.001) at 2,8,24-hour interval postoperative period. The time required for 1st rescue analgesia was longer in morphine (14 ±7.33 hours) as compared to clonidine (7 ±1.02 hours) (p<0.001). The total dose of rescue analgesic required in 24 hours was less (p<0.001) in morphine (75 ±48.25 mg) group. Hypotension bradycardia and sedation (p-value 0.028) were more in clonidine group as compared to morphine group.
Conclusion: Low dose morphine is better as an adjuvant than clonidine during spinal anaesthesia for relieving pain following caesarean section.
Alpha-2 agonist, Ancillary treatment, C-section, Opioid, Spinal anaesthesia
Date of Submission: Jun 08, 2020
Date of Peer Review: Jul 11, 2020
Date of Acceptance: Jul 25, 2020
Date of Publishing: Oct 01, 2020
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
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- Academic Search Complete Database
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- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
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- Popline (reproductive health literature)