Anaesthetic and postoperative analgesic effects of spinal clonidine as an additive to prilocaine in the transurethral resection of urinary bladder tumours

Santiveri, X.; Arxer, A.; Plaja, I.; Metje, Matthias; Martínez, Blanca; Villalonga, A; López, María Ángeles Abellán

doi:10.1017/s0265021502000959

Cited by 11 publications

(3 citation statements)

References 16 publications

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“…Santiveri et al (22) used 75 µg clonidine to prilocaine in patients undergoing transurethral resection of bladder tumours under spinal anaesthesia and reported prolonged sensory and motor blocks along with reduced postoperative analgesic requirement. De Kock et al (9) used spinal anaesthesia by adding varying doses of clonidine (0, 15, 45 or 75 µg) to ropivacaine in arthroscopy patients.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Dexmedetomidine Added to Spinal Levobupivacaine for Transurethral Endoscopic Surgery

et al. 2013

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While spinal anaesthesia has many advantages, the limited duration of action appears to be one of its downsides. Intrathecal α 2 agonists prolong the duration of action of local anaesthetics and reduce the required dose. The intrathecal use of clonidine, a partial α 2 adrenoceptor agonist, has been shown as an effective and safe procedure (1, 2). Dexmedetomidine is an α 2 receptor agonist and its α 2 /α 1 selectivity is 8 times higher than that of clonidine. In animal models, intrathecal dexmedetomidine has been demonstrated to have an analgesic effect (3). Levobupivacaine is a long-acting local anaesthetic with a pharmacological structure similar to that of bupivacaine. Levobupivacaine has been shown to have a larger safety margin and less neurotoxic and cardiotoxic sideeffects than bupivacaine (4).In this study, we aimed to investigate the influences of dexmedetomidine added to levobupivacaine on the time of onset of spinal block and durations of sensory and motor blocks in patients undergoing transurethral endoscopic surgery by spinal anaesthesia. Materials and MethodsThe present prospective, randomised, double-blind study was approved by the Ethics committee of Erciyes University Medical Faculty, and written informed consent was obtained from the patients. The study was conducted according to the Declaration of Helsinki. Patients were aged between 50-80 years with ASA physical status I-III and were scheduled for elective transurethral endoscopic surgery under spinal anaesthesia. Using the sealed envelope method, the patients were randomly allocated into two groups: Group L (n=30) or Group LD (n=30). Patients who were taking α-adrenergic agonist or antagonist therapy, as well as patients who had labile hypertension, autoimmune disorders, a known allergy to study drugs, heart block/dysrhythmia or any contraindication to spinal anaesthesia were excluded from the study. Pharmacological premedication was not applied to patients. After arrival at the operating theatre, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) measurements, peripheral oxygen saturation (SpO 2 ) and electrocardiography monitoring were measured by an ABSTRACTBackground: Intrathecal α2 agonists prolong the duration of action of local anesthetics and reduce the required dose. Dexmedetomidine is an α2 receptor agonist and its α2/α1 selectivity is 8 times higher than that of clonidine.

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Section: Discussionmentioning

confidence: 99%

The Effects of Dexmedetomidine Added to Spinal Levobupivacaine for Transurethral Endoscopic Surgery

et al. 2013

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“…The area of mechanical hyperalgesia at 72 h was 3±5 cm Some research has shown the usefulness of intrathecal clonidine in urology procedures, although there are some controversies. In a controlled, prospective, double-blind investigation with patients undergoing elective transurethral resection of bladder tumours under spinal anaesthesia [47] the authors found that adding clonidine 75 µg to prilocaine 75 mg increased the duration of sensory and motor block and reduced the need for additional postoperative analgesics by providing excellent analgesia for about 8 hours during recovery period. In a similar study, 25 µg spinal clonidine improved bupivacaine spinal anaesthesia: shorter time to achieve complete motor block and sensory block at T9 level, with longer postoperative analgesia.…”

Section: General Surgery and Urologic Proceduresmentioning

confidence: 99%

Intrathecal Clonidine as Spinal Anaesthesia Adjuvant — Is there a Magical Dose?

Whizar-Lugo¹,

Flores-Carrillo²,

Ramírez³

2014

Topics in Spinal Anaesthesia

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“…28 The addition of clonidine 75µg to prilocaine 75mg for subarachnoid anaesthesia reduced the need for additional postoperative analgesics for about 8 hours during recovery from transurethral resection of bladder tumors. 29 The addition of clonidine (15μg and 30μg) to bupivacaine prolonged time to first analgesic request. We have found similar evidence in present study.…”

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confidence: 99%

A comparative study of different adjuncts to enhance the effects of intrathecal bupivacaine

et al. 2017

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Background: Spinal anaesthesia is the commonly used technique for lower abdominal surgeries. Adjuvants to bupivacaine have been used to provide good quality of perioperative and postoperative analgesia. The aim of the study was to evaluate the effects of subarachnoid administration of bupivacaine with clonidine, magnesium, dexmedetomidine and saline group.Methods: The prospective, comparative single blind study included 120 patients in American society of anaesthesiologist (ASA) grade I and II, scheduled for lower abdominal surgeries were allocated in four groups. Each group included 15 mg bupivacaine with various adjuvants (30 µg clonidine, 50 mg magnesium sulphate and 3µg dexmedetomidine) were compared with saline group (group S).Results: Time of onset was earlier in groups D and C but delayed in group M. The total power regains (B0) in group D (250.8±18.87), group M (235.23±24.66) and group C (242.70±25.98) were significantly delayed (p<0.05) as compare with group S (180.07±18.53). Demand of analgesia was significantly earlier in group S as compared with groups C, M and D. Similarly, the time of two segment regression was significantly earlier in group S as compared with groups C, M and D (p<0.001). Patients were hemodynamically stable in groups D, C and M as compared to Group S.Conclusions: Dexmedetomidine and clonidine were equally effective and better as compared to magnesium as an adjunct to intrathecal bupivacaine.

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Anaesthetic and postoperative analgesic effects of spinal clonidine as an additive to prilocaine in the transurethral resection of urinary bladder tumours

Cited by 11 publications

References 16 publications

The Effects of Dexmedetomidine Added to Spinal Levobupivacaine for Transurethral Endoscopic Surgery

The Effects of Dexmedetomidine Added to Spinal Levobupivacaine for Transurethral Endoscopic Surgery

Intrathecal Clonidine as Spinal Anaesthesia Adjuvant — Is there a Magical Dose?

A comparative study of different adjuncts to enhance the effects of intrathecal bupivacaine

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