A Dose Response Study of Clonidine with Local Anesthetic Mixture for Peribulbar Block: A Comparison of Three Doses

Madan, Rashmi; Bharti, Neerja; Shende, Dilip; Khokhar, Sudershan; Kaul, H. L.

doi:10.1097/00000539-200112000-00056

Cited by 57 publications

(37 citation statements)

References 10 publications

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“…At a dose of 100-150 μg, clonidine resulted in a reduction in intraoperative stress associated with surgery and a decrease in IOP [17]. There are few studies using clonidine in ophthalmic blocks, most of them combining clonidine with local anesthetics for peribulbar blocks in cataract surgery [12][13][14]. Cataract surgery is recognized as a procedure associated with minimal pain; phacoemulsification is even performed with topical anesthesia [18].…”

Section: Discussionmentioning

confidence: 99%

“…Studies that used clonidine in ophthalmic blocks have reported contradictory results [11][12][13][14]22]. In a dose-response study of 2% lidocaine peribulbar block for cataract surgery, Madan et al found a dose-dependent prolongation of anesthesia and analgesia [12].…”

Section: Discussionmentioning

confidence: 99%

“…The addition of clonidine, an alpha(2)-agonist, to local anesthetics prolongs analgesia and akinesia in retrobulbar and peribulbar blocks for cataract surgery [11][12][13][14]. Our hypothesis was that the addition of clonidine to the local anesthetic mixture of the retrobulbar block would prolong the time to first analgesic request following vitreoretinal surgery (primary outcome).…”

Section: Introductionmentioning

confidence: 99%

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Supplementation of retrobulbar block with clonidine in vitreoretinal surgery: effect on postoperative pain

Yazbeck‐Karam¹,

Siddik-Sayyid²,

Nader³

et al. 2011

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Supplementation of retrobulbar block with clonidine in vitreoretinal surgery: effect on postoperative pain

Yazbeck‐Karam¹,

Siddik-Sayyid²,

Nader³

et al. 2011

Journal of Clinical Anesthesia

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“…[22][23][24] Clonidine has also been used to treat and/or prevent diarrhea, 25 manic and bipolar symptoms, 26 muscle rigidity and spasticity, 27 hyperactivity and attention deficit disorder in children, 28 withdrawal states, 29-32 congestive heart failure, 33 new-onset rapid atrial fibrillation, 34 angina pectoris, 35 myocardial infarction, 36 post-general anesthesia shivering 37 and agitation, 38-41 glaucoma, 42 chronic pain, 43 and syncope. 44 It can also supplement peribulbar, 45 epidural, 46 and intrathecal anesthesia. 47 Recently, clonidine has been utilized as a preoperative medication providing anxiolysis, 12,48 sedation, 49 analgesia, 11,50,51 hemodynamic stability, 13,50-53 saliva control, 23,54 and antiemetic effects.…”

Section: Discussionmentioning

confidence: 99%

Oral Clonidine Pretreatment Prior to Venous Cannulation

Hall

Rezvan

Tatakis

et al. 2006

Anesthesia Progress

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Clonidine is a preferential alpha-2 agonist drug that has been used for over 35 years to treat hypertension. Recently, it has also been used as a preoperative medication and as a sedative/anxiolytic drug. This randomized, double-blind, placebo-controlled crossover clinical trial characterized the effects of oral clonidine pretreatment on intravenous catheter placement in 13 patients. Parameters measured included the bispectral index (BIS), Observer's Assessment of Alertness/Sedation Scale (OAA/S), frontal temporal electromyogram (EMG), 30-Second Blink Count (Blink), Digit Symbol Substitution Test (DSST), State Anxiety Inventory (SAI), fingertip versus forearm skin temperatures, and multiple questionnaires. Oral clonidine significantly decreased SAI scores, OAA/S, EMG, and Blink, but did not cause statistically significant BIS or DSST reductions. Subjects preferred oral clonidine pretreatment prior to venipuncture compared to placebo. Questionnaires also indicated that clonidine provided minimal sedation, considerable anxiolysis, and some analgesia. Fingertip versus forearm skin temperature differentials were decreased. Reduced fingertip versus forearm temperature differentials suggest increased peripheral cutaneous blood flow prior to venous cannulation. Oral clonidine pretreatment not only helped control patient anxiety and pain but also provided cardiovascular stability.Key Words: Clonidine; Venous cannulation; BIS; SAI; DSST.I ntravenous (IV) catheters have become the accepted standard of care for general anesthesia and IV sedation. 1 Catheterization of peripheral veins can be made more comfortable using a variety of techniques, including local anesthesia infiltration, 2,3 nitrous oxide inhalation, 2,4,5 ethyl chloride topical, 4,6 eutectic mixture of local anesthetics (lidocaine-prilocaine) cream, 7,8 tetracaine patches, 9 and even midazolam nasal spray. 10 The goals of these methods are pain and anxiety reduction with minimal invasiveness and lack of significant complications. An additional benefit of some cannulation pretreatments is cutaneous vasodilation.Previous medical anesthesia/sedation studies have indicated that clonidine administration prior to surgery decreases pain 11,12 and anxiety 12 and also stabilizes blood pressure and heart rate by reduction of central sympathetic outflow. [13][14][15] Additional investigations have shown that clonidine pretreatment also increases skin temperature 16 and decreases the difference between fingertip and forearm temperatures. 17 These results suggest an increase in cutaneous blood flow. 18 The purpose of this randomized, double-blind, placebo-controlled crossover clinical trial was to characterize the sedative/anxiolytic effects and changes in skin temperatures of oral clonidine pretreatment prior to IV catheter placement. METHODSThe study protocol and informed consent form were approved by The Ohio State University Institutional Review Board. Inclusion criteria were (a) adults with American Society of Anesthesiologists ASA1 or ASA2 health status, (b) severe ...

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“…Opioids, clonidine, ketamine and prostigmine have been added to local anaesthetics and injected extradurally, intrathecally or in nerve plexuses for a more intense and prolonged analgesia 3,4,5,6,7,8 . Opioids are commonly added to local anaesthetic solutions to increase intensity and duration of anaesthesia by acting on opioid receptors present on the nerve terminals 9,10 . However, fentanyl has some side effects as vomiting and respiratory depression 7 .…”

Section: Introductionmentioning

confidence: 99%

Untitled

2018

IJPSR

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Background: Brachial plexus block provides minimal systemic impairment and excellent localized postoperative analgesia for upper extremity surgery. LA's such as lignocaine, bupivacaine and ropivacaine are widely used along with adjuvant to improve the quality, onset and duration of block and to decrease postoperative analgesic requirement and systemic side effects. Adjuvant like α-2 agonist (Clonidine), opioids etc. are been added to LA's. Clonidine is an imidazoline derivative with α-2 adrenergic agonistic activity. There has been seen a potentially clear synergism between clonidine and ropivacaine in various regional block anaesthesia. Material and Methods: In this randomized doubled blind controlled study, a total of 60 ASA grade I or II patients were taken and randomly allocated into 2 groups comprising 30 patients in each group. Group R includes patients which were given 30ml of 0.5% ropivacaine + 2ml normal saline and in Group RC 30 ml of 0.5% ropivacaine with 2 µg/kg clonidine in 2 ml NS. Sensory function was tested using pinprick and motor with concomitant inability to move the wrist and hand and the first analgesic request was noted. Statistical Analysis: Results were expressed as mean and standard deviation. P value of < 0.05 was considered statistically significant. Results: Duration of sensory, motor blockage and analgesia lasted longer in Group RC than Group R. There was no statistically significant in hemodynamic parameters, side effects and complication. Conclusion: Clonidine produces faster onset and longer duration of sensory, motor blockage, analgesia without any significant side effect and complication when used as an adjuvant to ropivacaine for supraclavicular brachial plexus block.

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A Dose Response Study of Clonidine with Local Anesthetic Mixture for Peribulbar Block: A Comparison of Three Doses

Cited by 57 publications

References 10 publications

Supplementation of retrobulbar block with clonidine in vitreoretinal surgery: effect on postoperative pain

Supplementation of retrobulbar block with clonidine in vitreoretinal surgery: effect on postoperative pain

Oral Clonidine Pretreatment Prior to Venous Cannulation

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