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Dexmeditomedine versus Clonidine as an adjuvant to Levobupivacaine in Paravertebral analgesia for acute post mastectomy pain


Sahar A. Tawfik , Maha A. Abd Elaleem , Mohamed M. Hassan , Ahmed H. Mohamed , Sally Mostafa Elhamoly

Abstract

Background: Acute postoperative pain is a problem after radical mastectomy. Treatment of postoperative pain following mastectomy is an area of increasing interest. The objective of our study is to compare the effect of addition of either dexmedetomidine or clonidine to levobupivacaine for prolongation of analgesia time. Methodology: 126 patients were divided randomly by computer randomization into 3 groups 42 patients each. Group L received 20 mL of 0.25% levobupivacaine. Group LD received dexmedetomedine (1mic/kg) added to 20 mL 0.25% levopubivacaine. Group LC received clonidine (1mic/kg) added to 20 mL 0.25% levopubivacaine. These injected into paravertebral space at T3 level under U/S guidance after finishing surgery while patient still under GA. Heart rate, systolic blood pressure, diastolic blood pressure, Ramsey sedation score, modified VAS, analgesia time, and analgesic requirements were followed. Results: There was no difference between dexmedetomedine group and clonidine group) in modified visual analogue score, analgesia time, and analgesic requirements. But there was significant statistical difference between both interactive (dexmedetomedine and clonidine) groups and control group (levobupivacaine). Conclusion: Addition of clonidine and dexmedetomedine to levopubivacaine in TPVB after modified radical mastectomy reduce postoperative pain scores, prolong duration of pain free periods, delay requirement for first rescue analgesia, and decrease analgesic requirement, with no statistical significant difference in analgesic duration between both additives.



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