Clonidine as an Adjuvant to Intrathecal Local Anesthetics for Surgery

Elia, Nadia; Culebras, Xavier; Mazza, Christian; Schiffer, Eduardo; Tramèr, Martin R.

doi:10.1097/00115550-200803000-00011

Cited by 22 publications

(2 citation statements)

References 23 publications

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“…This is in agreement with the results of other studies. 5,9,17,19 In our study the duration of analgesia time (time to first complaint of pain) was significantly longer in study group.…”

Section: Discussionsupporting

confidence: 41%

Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries: study in a Kashmiri population

Shah¹,

Kundal²,

Gupta

et al. 2012

Sri Lankan J Anaesthesiol

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“…This is in agreement with the results of other studies. 5,9,17,19 In our study the duration of analgesia time (time to first complaint of pain) was significantly longer in study group.…”

Section: Discussionsupporting

confidence: 41%

Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries: study in a Kashmiri population

Shah¹,

Kundal²,

Gupta

et al. 2012

Sri Lankan J Anaesthesiol

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“…But there is a need to increase the intensity and duration of sensory blockade without increasing the intensity and duration of motor blockade to prolong the duration of postoperative analgesia and promote early ambulation. The addi-tion of opioids has been suggested as a method to accomplish these goals [1,2].…”

Section: Introductionmentioning

confidence: 99%

Comparative study of intrathecal tramadol and fentanyl as adjuvants in lower abdominal surgeries

Rani

Rao

Vaishnavi

2022

SR:MS

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Spinal anesthesia is preferred choice of anesthesia in lower abdominal surgeries for a long time. However, the problem with this is limited duration of action, so for long duration surgeries alternatives are required. The aim: to compare the intra-operative effects of a low dose of intrathecal tramadol and intrathecal fentanyl with hyperbaric bupivacaine hydrochloride. Materials and methods: prospective randomized control study for a duration of study is one year. 50 patients, aged 18 years to 60 years, belonging to ASA physical status I and II, posted for elective lower abdominal surgeries under spinal anaesthesia were chosen. These patients were divided into two groups: group BT- this group of patients received 2.5 mL volume of 0.5 % hyperbaric bupivacaine with 25 mg of tramadol intrathecally. Group BF- this group of patients received 2.5 mL volume of 0.5 % hyperbaric bupivacaine with 25 μg of fentanyl intrathecally. Results: demographic parameters in both the groups are not statistically significant. The association between the differences in duration of surgeries of both the study groups is not statistically. The association between the differences in mean time of onset of sensory block and motor block of both the study groups was comparable with p>0.05 The duration of sensory block (analgesia) and duration of motor block difference between the two means was statistically significant with p<0.0000001. The difference between the mean VAS score at 3 hours and at 20 hours was statistically significant with p<0.05. Among the study BT group, 52 % needed 2 analgesics and 48 % needed 3 doses of analgesics. Among BF group, 6 % needed only one dose of analgesics and 44 % needed 2 doses of analgesics. The difference between the two was statistically significant with p<0.000002. The association between the hemodynamic variables between both the groups at the end of procedure was statistically significant with p<0.05. Conclusions: Intrathecal fentanyl and tramadol produced a similar onset of sensory and motor blocks. Fentanyl provided better duration and quality of postoperative analgesia compared to tramadol

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Effects of fadolmidine, an α₂‐adrenoceptor agonist, as an adjuvant to spinal bupivacaine on antinociception and motor function in rats and dogs

Leino

Viitamaa

Salonen

et al. 2021

Pharmacology Res & Perspec

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α 2 ‐Adrenoceptor agonists such as clonidine and dexmedetomidine are used as adjuvants to local anesthetics in regional anesthesia. Fadolmidine is an α 2 ‐adrenoceptor agonist developed especially as a spinal analgesic. The current studies investigate the effects of intrathecally administered fadolmidine with a local anesthetic, bupivacaine, on antinociception and motor block in conscious rats and dogs. The antinociceptive effects of intrathecal fadolmidine and bupivacaine alone or in combination were tested in the rat tail‐flick and the dog's skin twitch models. The durations of motor block in rats and in dogs were also assessed. In addition, the effects on sedation, mean arterial blood pressure, heart rate, respiratory rate and body temperature were evaluated in telemetrized dogs. Concentrations of fadolmidine in plasma and spinal cord were determined after intrathecal and intravenous administration in rats. Co‐administration of intrathecal fadolmidine with bupivacaine increased the magnitude and duration of the antinociceptive effects and prolonged motor block without hypotension. The interaction of the antinociceptive effect was synergistic in its nature in rats. Concentration of fadolmidine in plasma was very low after intrathecal dosing. Taken together, these studies show that fadolmidine as an adjuvant to intrathecal bupivacaine provides enhanced sensory‐motor block and enables a reduction of the doses of both drugs. The results indicate that co‐administration of fadolmidine with intrathecal bupivacaine was able to achieve an enhanced antinociceptive effect without hypotension and could thus represent a suitable combination for spinal anesthesia.

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Clonidine as an Adjuvant to Intrathecal Local Anesthetics for Surgery

Cited by 22 publications

References 23 publications

Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries: study in a Kashmiri population

Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries: study in a Kashmiri population

Comparative study of intrathecal tramadol and fentanyl as adjuvants in lower abdominal surgeries

Effects of fadolmidine, an α₂‐adrenoceptor agonist, as an adjuvant to spinal bupivacaine on antinociception and motor function in rats and dogs

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Clonidine as an Adjuvant to Intrathecal Local Anesthetics for Surgery

Cited by 22 publications

References 23 publications

Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries: study in a Kashmiri population

Efficacy of analgesic effect of low dose intrathecal clonidine as adjuvant to bupivacaine in urogenital surgeries: study in a Kashmiri population

Comparative study of intrathecal tramadol and fentanyl as adjuvants in lower abdominal surgeries

Effects of fadolmidine, an α2‐adrenoceptor agonist, as an adjuvant to spinal bupivacaine on antinociception and motor function in rats and dogs

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Product

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Effects of fadolmidine, an α₂‐adrenoceptor agonist, as an adjuvant to spinal bupivacaine on antinociception and motor function in rats and dogs