"EFFECTIVENESS OF LOCAL ANAESTHESIA (CLONIDINE AND FENTANYL) INFILTRATION FOR POST - NASAL SURGERIES."
Main Article Content
Keywords
Clonidine, Fentanyl, Nasal Surgeries, Local Anesthesia, Postoperative Pain, Block Anesthesia
Abstract
Background: Postoperative pain management following nasal surgeries is crucial for improving patient comfort and minimizing analgesic requirements. This study aimed to evaluate the effectiveness of local infiltration anesthesia combining clonidine and fentanyl in improving postoperative pain relief and overall comfort levels in patients undergoing nasal surgeries. The study compared this combination with standard infiltration anesthesia using lignocaine with adrenaline.
Methods: A total of 60 patients undergoing nasal surgeries such as Functional Endoscopic Sinus Surgery (FESS), septoplasty, dacryocystorhinostomy, and nasal bone fracture reduction were enrolled in the study. Patients were randomized into two groups: the study group (n=30) received block anesthesia consisting of Inj. Lignocaine 2% (3ml), Inj. Lignocaine with Adrenaline 2% (3ml), Inj. Sensorcaine 0.5% (3ml), Inj. Fentanyl 50 µg/ml (0.5ml), and Inj. Clonidine 100 µg/ml (0.5ml); the control group (n=30) received infiltration anesthesia with Inj. Lignocaine with Adrenaline 2% (10ml). Discomfort levels were evaluated at 6 hours, 12 hours, Day 1, Day 2, and Day 7 postoperatively using predefined criteria: no discomfort, tolerable discomfort, and intolerable discomfort. Statistical analysis was performed using the Chi-square test.
Results: Patients in the study group consistently experienced lower discomfort levels across all postoperative time points. At 6 hours, 30% of the study group reported no discomfort compared to only 15% in the control group (p<0.05). At 12 hours, 33.33% of the study group reported no discomfort versus 16.67% in the control group (p<0.05). By Day 2, no patients in the study group experienced intolerable discomfort compared to 6.67% in the control group (p<0.01). On Day 7, 48.33% of patients in the study group experienced no discomfort compared to 36.67% in the control group (p<0.05). The improved outcomes in the study group demonstrate the enhanced analgesic effect of clonidine and fentanyl infiltration.
Conclusion: The combination of clonidine and fentanyl in block anesthesia effectively reduced postoperative discomfort and improved overall patient comfort compared to infiltration anesthesia using lignocaine with adrenaline alone. The significant reduction in intolerable discomfort and prolonged analgesic effect supports the use of this combination as an effective postoperative pain management strategy in nasal surgeries.
Methods: A total of 60 patients undergoing nasal surgeries such as Functional Endoscopic Sinus Surgery (FESS), septoplasty, dacryocystorhinostomy, and nasal bone fracture reduction were enrolled in the study. Patients were randomized into two groups: the study group (n=30) received block anesthesia consisting of Inj. Lignocaine 2% (3ml), Inj. Lignocaine with Adrenaline 2% (3ml), Inj. Sensorcaine 0.5% (3ml), Inj. Fentanyl 50 µg/ml (0.5ml), and Inj. Clonidine 100 µg/ml (0.5ml); the control group (n=30) received infiltration anesthesia with Inj. Lignocaine with Adrenaline 2% (10ml). Discomfort levels were evaluated at 6 hours, 12 hours, Day 1, Day 2, and Day 7 postoperatively using predefined criteria: no discomfort, tolerable discomfort, and intolerable discomfort. Statistical analysis was performed using the Chi-square test.
Results: Patients in the study group consistently experienced lower discomfort levels across all postoperative time points. At 6 hours, 30% of the study group reported no discomfort compared to only 15% in the control group (p<0.05). At 12 hours, 33.33% of the study group reported no discomfort versus 16.67% in the control group (p<0.05). By Day 2, no patients in the study group experienced intolerable discomfort compared to 6.67% in the control group (p<0.01). On Day 7, 48.33% of patients in the study group experienced no discomfort compared to 36.67% in the control group (p<0.05). The improved outcomes in the study group demonstrate the enhanced analgesic effect of clonidine and fentanyl infiltration.
Conclusion: The combination of clonidine and fentanyl in block anesthesia effectively reduced postoperative discomfort and improved overall patient comfort compared to infiltration anesthesia using lignocaine with adrenaline alone. The significant reduction in intolerable discomfort and prolonged analgesic effect supports the use of this combination as an effective postoperative pain management strategy in nasal surgeries.
References
1. Naja M, El-Rajab M, Kabalan W, Itani M, Kharma K, Al Tannir MA, Ziade MF. Effectiveness of local anaesthesia (clonidine and fentanyl) infiltration for post-submucosal resection pain relief: a randomized, double-blinded clinical trial. J Laryngol Otol. 2006;121:19-24.
2. Kumari I, Naithani U, Harsha, Singhal Y, Meena K, Mohan M. Clonidine as an adjuvant in monitored anaesthesia care for ENT surgeries: A prospective, randomized, double blind placebo controlled study. [Unpublished Journal]. 2019;260-268.
3. Naja M, El-Rajab M, Kabalan W, Itani M, Kharma K, Al Tannir MA, Ziade MF. Effectiveness of local anaesthesia (clonidine and fentanyl) infiltration for post-submucosal resection pain relief: a randomized, double-blinded clinical trial. J Laryngol Otol. 2006;121:19-24.
4. Rai N, Mathew ME, Gogna RL. Comparative Study Intrathecal Clonidine versus Intrathecal Fentanyl in Hyperbaric Bupivacaine for Spinal Anaesthesia and Postoperative Analgesia in Patients Undergoing Lower Limb Surgeries. [Unpublished Journal]. 2021.
5. Ahuja S, Aggarwal M, Joshi N, Chaudhry S, Madhu S. Efficacy of Caudal Clonidine and Fentanyl on Analgesia, Neuroendocrine Stress Response and Emergence Agitation in Children Undergoing Lower Abdominal Surgeries Under General Anaesthesia with Sevoflurane. J Clin Diagn Res. 2015;9(9):UC01-5.
6. Samantaray A, Rao M, Chandra A. The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia. Indian J Anaesth. 2012;56:359-364.
7. Kumie FT, Hailekiros A, Eshetie S. Comparison of the postoperative analgesic effects of intrathecal Clonidine and Fentanyl as adjuvants: Meta Analysis of randomized control trials. J Anesth Crit Care. 2018;11.
8. Vinayak A, Rajarathna K, Raghavendra BS. Effect of clonidine as an add-on to fentanyl premedication on post-operative pain in patients undergoing spine surgeries: A randomized study. Natl J Physiol Pharm Pharmacol. 2019.
2. Kumari I, Naithani U, Harsha, Singhal Y, Meena K, Mohan M. Clonidine as an adjuvant in monitored anaesthesia care for ENT surgeries: A prospective, randomized, double blind placebo controlled study. [Unpublished Journal]. 2019;260-268.
3. Naja M, El-Rajab M, Kabalan W, Itani M, Kharma K, Al Tannir MA, Ziade MF. Effectiveness of local anaesthesia (clonidine and fentanyl) infiltration for post-submucosal resection pain relief: a randomized, double-blinded clinical trial. J Laryngol Otol. 2006;121:19-24.
4. Rai N, Mathew ME, Gogna RL. Comparative Study Intrathecal Clonidine versus Intrathecal Fentanyl in Hyperbaric Bupivacaine for Spinal Anaesthesia and Postoperative Analgesia in Patients Undergoing Lower Limb Surgeries. [Unpublished Journal]. 2021.
5. Ahuja S, Aggarwal M, Joshi N, Chaudhry S, Madhu S. Efficacy of Caudal Clonidine and Fentanyl on Analgesia, Neuroendocrine Stress Response and Emergence Agitation in Children Undergoing Lower Abdominal Surgeries Under General Anaesthesia with Sevoflurane. J Clin Diagn Res. 2015;9(9):UC01-5.
6. Samantaray A, Rao M, Chandra A. The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia. Indian J Anaesth. 2012;56:359-364.
7. Kumie FT, Hailekiros A, Eshetie S. Comparison of the postoperative analgesic effects of intrathecal Clonidine and Fentanyl as adjuvants: Meta Analysis of randomized control trials. J Anesth Crit Care. 2018;11.
8. Vinayak A, Rajarathna K, Raghavendra BS. Effect of clonidine as an add-on to fentanyl premedication on post-operative pain in patients undergoing spine surgeries: A randomized study. Natl J Physiol Pharm Pharmacol. 2019.
Article Sidebar
Published
Mar 13, 2025
Article Details
How to Cite
Dr. Tejas Sambhaji Tambule, Dr. Akash Sambhaji Tambule, & Dr. Gayatri Adinath Gathekar. (2025). "EFFECTIVENESS OF LOCAL ANAESTHESIA (CLONIDINE AND FENTANYL) INFILTRATION FOR POST - NASAL SURGERIES.". Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 348-354. https://doi.org/10.53555/arzbay23
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Dr. Tejas Sambhaji Tambule
ENT surgeon, Civil Hospital, Parbhani.
Dr. Akash Sambhaji Tambule
Assistant Professor, Department of Anaesthesia, K J Somaiya Medical College, Mumbai
Dr. Gayatri Adinath Gathekar
ENT surgeon (Medical officer) civil hospital, Parbhani.
How to Cite
Dr. Tejas Sambhaji Tambule, Dr. Akash Sambhaji Tambule, & Dr. Gayatri Adinath Gathekar. (2025). "EFFECTIVENESS OF LOCAL ANAESTHESIA (CLONIDINE AND FENTANYL) INFILTRATION FOR POST - NASAL SURGERIES.". Journal of Population Therapeutics and Clinical Pharmacology, 32(2), 348-354. https://doi.org/10.53555/arzbay23