A Comparative Study of Morphine and Clonidine as an Adjunct to Ropivacaine in Paravertebral Block for Modified Radical Mastectomy.

clonidine morphine paravertebral block post-operative pain ropivacaine

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Aug 2023
Historique:
accepted: 04 08 2023
medline: 5 9 2023
pubmed: 5 9 2023
entrez: 5 9 2023
Statut: epublish

Résumé

Background General anesthesia (GA) is a standard for breast malignant surgery. The issue of postoperative pain as well as the high occurrence of nausea and vomiting have prompted the quest for a superior methodology for tormenting the executives with fewer complications. Over the most recent couple of years, paravertebral block (PVB) has acquired huge fame either in combination with GA or alone for anesthetic management. In this study, we aim to evaluate the efficacy of morphine and clonidine as an adjunct to ropivacaine in PVB in breast cancer patients undergoing modified radical mastectomy. Methods In this study, a total of 90 patients were divided into the following three groups (30 each) based on a computer-generated random table. Group C (control): PVB with 0.25% ropivacaine (19 ml) 1 ml saline; Group M: PVB with 0.25% ropivacaine (19 ml) + 20 microgram/kg body weight morphine; Group N: PVB with 0.25% ropivacaine (19 ml) + 1.0 microgram/kg body weight clonidine. The postoperative pain intensity was recorded using the visual analog scale (VAS), and sedation was observed by the Ramsay Sedation Scale (RSS) score. Results The VAS was similar at zero hours, two hours, and four hours in the postoperative period among all the groups. There was a significant (p = 0.003) difference in VAS from six hours to 20 hours in the postoperative period among the groups. A significant (p < 0.05) difference was observed among the groups at eight hours to 20 hours. The first requirement of analgesia was significantly (p = 0.001) higher in Group N (7.70 ± 1.74) than in Group C (4.43 ± 1.43) and Group M (7.33 ± 2.21). Conclusion Morphine in the PVB provides better postoperative analgesia. The consumption of rescue analgesia was significantly reduced in the morphine group as compared to the clonidine group. The procedure also proved to be safe as no complication was encountered in the PVB in our study.

Identifiants

pubmed: 37667700
doi: 10.7759/cureus.42950
pmc: PMC10475293
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e42950

Informations de copyright

Copyright © 2023, Kumar et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Mukesh Kumar (M)

Emergency Medicine, King George's Medical University, Lucknow, IND.

Rajni Gupta (R)

Anesthesiology, King George's Medical University, Lucknow, IND.

Prateek Kumar Dinkar (PK)

Emergency Medicine, King George's Medical University, Lucknow, IND.

Haider Abbas (H)

Emergency Medicine, King George's Medical University, Lucknow, IND.

Classifications MeSH