|Year : 1984 | Volume
| Issue : 4 | Page : 207-9
Comparative study of centbucridine and lignocaine for subarachnoid block.
DD Dasgupta, BA Tendulkar, TT Paul, RS Satoskar
D D Dasgupta
|How to cite this article:|
Dasgupta D D, Tendulkar B A, Paul T T, Satoskar R S. Comparative study of centbucridine and lignocaine for subarachnoid block. J Postgrad Med 1984;30:207-9
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Dasgupta D D, Tendulkar B A, Paul T T, Satoskar R S. Comparative study of centbucridine and lignocaine for subarachnoid block. J Postgrad Med [serial online] 1984 [cited 2020 Oct 27 ];30:207-9
Available from: https://www.jpgmonline.com/text.asp?1984/30/4/207/5445
Centbucridine (4-N-butylamino 1,2,3,4 tetrahydroacridine hydrochloride) is a new local anesthetic agent synthesized at the CDRI, Lucknow., The compound is five times as potent as lignocaine while its LD50 is ¼th that of lignocaine. Our earlier studies demonstrated the effectiveness of Centbucridine for infiltration, spinal and dental anesthesia in the concentration much lower than lignocaine.,, This study describes the results of Centbucridine 1% as a spinal anesthetic as compared to lignocaine 5% in a double-blind, randomised study in 152 patients posted for elective surgery.
MATERIAL AND METHODS
Patients with age range between 18 and 60 years, admitted to the K.E.M. Hospital for elective surgery were included in this study after obtaining their informed consent. Seventyseven patients received Centbucridine and 75 patients received lignocaine. Both drugs were supplied in identical looking ampoules, each containing 1 ml of Centbucridine 1% or lignocaine 5%.
All patients were given atropine 0.6 mg 15 minutes prior to surgery. No other pre-operative sedation was used. The drug was administered by spinal route in L3-L4 interspace using 22 gauge needle. An intravenous infusion was started in every patient simultaneously.
Parameters noted were (1) time taken for onset and complete anesthesia-both sensory and motor; (2) duration of anesthesia as judged by return of sensory and motor function; (3) duration of surgery; (4) need for intra-operative medication consisting of pethidine, phenergan or diazepam; (5) need for administering supplemental anesthesia in the form of I.V. thiopentone sodium, nitrous oxide, O2 and halothane. Blood pressure, heart rate and respiratory rate were recorded at 5, 15, 30, 45, 60, 75 and 90 minutes after the injection. Adverse reactions like headache, vomiting, backache, retention of urine or neurological deficit were looked for during the first 24 hours after the operation.
Results were classified as 'good' if the surgical procedure was completed without any need for any supplementation to subarachnoid block and 'poor' if no anesthetic effect was observed and had to supplement with general anesthesia. Cases where anesthetic effect was observed but intra-operative medication was required due to restlessness or complaint of pain were considered as 'fair' response. Data was decoded at the end of the study any.. the results analysed using Student's 't' test.
RESULTS AND DISCUSSION
Distribution of patients in relation to operative procedure is liven in [Table 1].
There was a fairly equitable distribution of cases into two groups. The mean volume in ml of drug used in the two groups was 1.64 ± 0.14 (SD) of centbucridine and 1.62 ± 0.11 (SD) for lignocaine. Difference was not statistically significant. Mean values for the onset and duration of anesthesia with the two drugs, for both sensory and motor function, are shown in [Table 2]. With centbucridine, the time taken for loss of sensation was 3.52 min. ± 2.15 (SD) and 4.38 min. ± 2.29 (SD) for loss of motor power as compared to 3.31 min. ± 2.67 (SD) and 3.99 min. ± 2.80 (SD) respectively for lignocaine. Similarly, the duration of anesthesia with centbucridine was 102.30 min. ± 30.04 (SD) and 103.93 min. ± 32.46 (SD) as against 10.60 min. ± 33.00 (SD) and 106.03 min. ± 28.95 (SD) with lignocaine for the return of sensory motor functions respectively. As regards overall assessment, 65 patients in the centbucridine group and 68 patients in the lignocaine group were rated as good; 7 in the centbucridine group and 3 in the lignocaine group as 'fair' while 5 in the centbucridine group and 4 in the lignocaine group were classified as 'poor' responders.
Adverse effects are listed in [Table 3]
Fourteen patients in the lignocaine group complained of backache as compared to 5 in the centbucridine group. Bradycardia was noted in seven patients in each group for which atropine 0.5 mg was given I.V. Two patients in the centbucridine group complained of tingling and pain in the legs as soon as the drug was injected, the pain being more of a cramp-like sensation. There were no neurological defects seen, either immediatly or, residually in either groups. The systolic blood pressure dropped in some patients belonging to both groups, but no symptoms were manifested, probably because, the patients already had LV. infusion started on them. No pressor agents were given to counteract this fall in B.P. Apart from these side effects, both drugs were well tolerated by the patients.
These results confirm the earlier findings, that given by spinal route; cent bucridine 1% produces anesthetic effect comparable to 5% lignocaine and hence, can be used as a substitute for lignocaine.
|1||Dasgupta, D., Garasia, M., Gupta, K. C. and Satoskar, R. S.: Randomised double blind study of centbucridine and lignocaine for subarachnoid block. hid. I. Med. Res., 77. 512-515, 1983.|
|2||Gupta. P. P., Tangri, A. N., Saxena, R. C. and Dhawan, B. N.: Clinical pharmacology studies on 4-N-butylamirio - 1, 2, 3, 4-tetrahydroacridine hydrochloride (centbucridine), a new local anaesthetic agent. Ind. J. Expt. Biol., 20: 344-346, 1982.|
|3||Patnaik, G. K. and Dhawan, B. N.: Pharmacological study of 4-N-butylamino 1, 2, 3, 4-tetrahydroacridine hydrochloride (centbucridine) - a new local anesthetic agent, Ind. J. Expt. Biol., 20: 330-333, 1982.|
|4||Patnaik, G. K., Rastogi, S. N., Anand. N. and Dhawan, B. N.: Evaluation of local anesthetic activity of 4-N-butylamino 1, 2, 3, 4, tetrahydro-acridine hydrochloride (centbucridine)-a 4-substituted polymethylene quinoline. Ind. J. Exp. Biol., 20: 327-329, 1982.|
|5||Samsi, A. B., Bhalerao, R. A., Shah, S. C., Mody, B. B., Paul, T. and Satoskar, R. S.: Evaluation of centbucridine as a local anesthetic. Anesth. Analg., 62: 109-111, 1983.|
|6||Suri, Y. V., Singhal, A. P., Phadke, V. K., Rajauria, S. S., Singh, D., Gupta, P. P., and Dhawan, B. N.: Double blind study on centbucridine for subarachnoid and extradural anesthesia. Ind. J. Med. Res., 76: 875-881, 1982.|
|7||Vaccharajani, G. N., Parikh, N., Paul, T. and Satoskar, R. S.: A comparative study of centbucridine and lidocaine in dental extraction. Internat. J. Clin. Pharm:. and Res., 3: 251-255, 1983|