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Anestesia en México
On-line version ISSN 2448-8771Print version ISSN 1405-0056
Abstract
MASCARENO-HERNANDEZ, E.; LABRA-RUBIO, L. and SAENZ-SANCHEZ, M.L.. Ropivacaine with Clonidine vs Ropivacaine for postoperative analgesia in hip surgery in older adults. Anest. Méx. [online]. 2018, vol.30, n.2, pp.20-27. ISSN 2448-8771.
Introduction:
Postoperative analgesia reduces morbidity, appropriate anesthetic management including spinal adjuvants that enhance the quality of anesthesia and postoperative analgesia is vital.
Objective:
Estimate the postoperative analgesia with ropivacaine hip surgery plus clonidine against ropivacaine via subarachnoid in older adults.
Materials and methods:
Prospective, controlled and randomized clinical study, 88 patients divided into two groups of 44 patients each, under subarachnoid anesthesia were studied. The first group received 0.75% ropivacaine, 15 mg as the only medication by the subarachnoid route; the second group received 0.75% ropivacaine, 15 mg plus 15 μg of clonidine in the same way. Post-operative pain intensity was scored on a numerical scale. Tramadol or buprenorphine was used as a rescue medication.
Results:
The ropivacaine plus clonidine group, decreased the consumption of postoperative rescue analgesics. The installation of motor and sensory block was faster in the ropivacaine plus clonidine group. The duration of analgesia for the ropivacaine plus clonidine group was 9.36 hours, and for the ropivacaine group it was 8.50, even before requiring rescue analgesics. The intensity of pain in the ropivacaine group with clonidine presented a lower degree of pain, which on average was 1.28 ± 0.81. (95% CI, 1.11 1.45), vs. 1.87 ± 1.1, (95% CI, 1.63 2.10). (P = 0.049), for the ropivacaine group.
Conclusions:
Both drugs are effective for treating postoperative pain in surgery of the hip in elderly patients. There is a slight improvement with ropivacaine more clonidine, probably derived dose and ropivacaine which is a longlasting local anesthetic.
Keywords : Postoperative analgesia; ropivacaine; clonidine; older adults; hip surgery.