title: Comparative study between epidural morphine and bupivacaine with epidural clonidine and bupivacaine for postoperative pain relief in abdominal surgeries.
abstract: BACKGROUND
  Many adjuvants are used to increase the efficacy of epidural local anesthetics for postoperative analgesia.
  
  
  OBJECTIVE
  The aim was to compare the efficacy of epidural morphine (0.1 mg/kg) and clonidine (2 μg/kg) with bupivacaine (0.125%) for postoperative analgesia in abdominal surgeries.
  
  
  METHODS
  Double-blind retrospective randomized study.
  
  
  METHODS
  All the patients (n = 60) varying from age group belonging to American Society of Anesthesiologists I-II were randomly allocated to receive epidural analgesia Group A - Morphine (0.1 mg/kg). + Bupivacaine (0.125%) (n = 30), Group B - Clonidine (2 μ/kg) + Bupivacaine (0.125%) (n = 30). We monitored vitals and requirement of inhalational gases intra-operatively, pain by visual analogue score (VAS) and vitals postoperatively. We used rescue analgesics (injection diclofenac 1 mg/kg intravenous) when VAS score > 5. Postoperatively, various parameters were monitored for first 2 h at intervals of 30 min and at 4, 8, 12, 16, and 24 hourly intervals after giving 1(st) dose.
  
  
  METHODS
  Continuous data are analyzed by Student's t-test (paired 't'-test for intragroup variations and unpaired 't'-test for intergroup variations). Chi-square test was used for categorical data. A P ≤ 0.05 was considered to be statistically significant.
  
  
  RESULTS
  Mean duration of analgesia was 8.35 ± 0.42 h in Group A (morphine) and 7.45 ± 0.44 h in Group B (clonidine). This difference was statistically significant (P < 0.001), indicating a prolongation of analgesia in group morphine. There was no need of rescue analgesia in any subjects. Group A patients were hemodynamically stable and required less inhalation agents intra-operatively compared to group B patients.
  
  
  CONCLUSIONS
  Epidural morphine plus bupivacaine has a longer duration of analgesia and greater hemodynamic stability as compared to epidural clonidine plus bupivacaine for postoperative analgesia in abdominal surgeries.
authors.affiliation: Department of Anaesthesiology, B J Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Tapan J
authors.initials: TJ
authors.lastname: Parikh
authors.affiliation: Department of Anaesthesiology, B J Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Vishal
authors.initials: V
authors.lastname: Divecha
authors.affiliation: Department of Anaesthesiology, B J Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Divyang
authors.initials: D
authors.lastname: Dalwadi
keywords: Epidural; postoperative analgesia; visual analog score