title: Evaluation of clonidine as an adjuvant to bupivacaine in wound infiltration for providing postoperative analgesia after abdominal hysterectomy.
abstract: BACKGROUND
  Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia.
  
  
  OBJECTIVE
  To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy.
  Prospective, randomized, double-blinded study.
  
  
  METHODS
  One hundred patients of American Society of Anesthesiologists I-II posted for abdominal hysterectomy were randomly allotted to two groups. Group A received wound infiltration with 45 ml of 0.25% bupivacaine with 3 μg/kg clonidine while Group B received wound infiltration with 45 ml of 0.25% bupivacaine. A standard general anesthesia technique was used in all the patients. Postoperative analgesia was provided with injection ketorolac 0.5 mg/kg intravenous infusion and tramadol being the rescue analgesic. Postoperative pain score, duration of effective analgesia before the first rescue analgesic, percentage of patients requiring rescue analgesic at different time intervals, and total number of rescue analgesic doses in 24 h were compared between the groups.
  
  
  METHODS
  Difference between the bivariate samples in independent groups with Mann-Whitney U-test. For categorical data, Chi-square test was used.
  
  
  RESULTS
  Clonidine group has better pain score, longer duration of effective analgesia, lower percentage of patients requiring rescue analgesic, and less number of doses of rescue analgesia in the first 24 h.
  
  
  CONCLUSIONS
  We conclude that Clonidine 3 μg/kg is an effective adjuvant to bupivacaine for wound infiltration in terms of quality and duration of postoperative analgesia following total abdominal hysterectomy.
authors.affiliation: Department of Anesthesiology, Sri Ramachandra Medical College and Research Centre, Sri Ramachandra University, Chennai, India.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Selvaraj
keywords: Analgesia; bupivacaine; hysterectomy