Clinical efficacy of oral gabapentin versus clonidine for preemptive analgesia in knee arthroplasty under epidural anesthesia with 0.75% Ropivacaine – A comparative study

Abstract

Background: The preemptive analgesia for knee arthroscopic repair may reduce the postoperative pain without affecting the mobility of patients. The present study was designed to compare the clinical efficacy of oral gabapentin with clonidine as preemptive analgesic to epidural ropivacaine (0.75%) for knee arthroscopic repair, done under epidural anesthesia. Patients and Methods: Sixty adult patients of both genders of the American Society of Anesthesiologists physical status I and II aged 20–58 years, scheduled for knee arthroscopic repair under epidural anesthesia, were randomized into two groups of 30 patients each. Patients of Group RG were given oral gabapentin 300 mg, and patients of Group RC received oral clonidine 100 μg, 90 min before surgery with sip of water. All patients received epidural anesthesia with 15 ml of 0.75% ropivacaine. Groups were compared for onset and duration of sensory and motor blockade and postoperative analgesia as primary end points. Intraoperative hemodynamic changes, sedation score, or any side effects were evaluated as secondary end points. Results: The onset of complete sensory block to T10 (15.4 ± 4.7 vs. 17.5 ± 3.8 min) and time to achieve complete motor block (23.7 ± 3.3 vs. 26.9 ± 1.4 min) was earlier in patients of Group RC. Postoperative analgesia was prolonged in patients of Group RG (248.17 ± 19.6 vs. 217.36 ± 12.3 min). Intraoperative hemodynamic changes showed no significant difference. There was an increased incidence of nausea and vomiting in clonidine group. Conclusion: Oral gabapentin proved to be better as preemptive adjuvant for providing postoperative analgesia and good sedation during knee arthroscopic repair.

Keywords

• Clonidine
• epidural anesthesia
• gabapentin
• knee arthroscopic repair
• preemptive analgesia
• ropivacaine