Conduction Block by Clonidine Is Not Mediated by α2-Adrenergic Receptors in Rat Sciatic Nerve Fibers

Leem, Joong Woo; Han, Song Min; Yoon, Mi Ja; Sim, Ji Yeon; Leem, Seung Woon

doi:10.1097/00115550-200011000-00013

Cited by 11 publications

(4 citation statements)

References 17 publications

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“…(3,24) Although it is unlikely that the spinal and supraspinal effect is the mechanism that prolongs the analgesic effect of clonidine deposited at peripheral sites, analgesic agent, (25) suggesting that synergistic activity is more likely the mechanism for the prolonged analgesic duration observed with the use of clonidine. The direct action of clonidine, independent of its action on α2 receptor nerve fibre conduction, has been demonstrated in some studies, (16,26,27) indicating another possible mechanism for its action as a local anaesthetic additive. Hutschala et al have postulated that the effect of clonidine is local.…”

Section: Discussionmentioning

confidence: 95%

Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study

Rohan¹,

Singh²,

Khurana³

2014

smedj

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Section: Discussionmentioning

confidence: 95%

Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study

Rohan¹,

Singh²,

Khurana³

2014

smedj

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“…This current normally functions to restore nerves from a hyperpolarized state to resting potential for a subsequent action potential. The effect appears to be more profound on C-fibers (pain fibers) than Aα fibers (motor fibers), thereby making the effects potentially more sensory specific [16][17][18]. Clonidine has often been used as an adjuvant to local anaesthetics in SGBs [19].…”

Section: Discussionmentioning

confidence: 99%

A comparison of analgesic efficacy and safety of clonidine and methylprednisolone as additives to 0.25% ropivacaine in stellate ganglion block for the treatment of complex regional pain syndrome: a prospective randomised single blind study

et al. 2023

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Background The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18–70 years with American Society of Anaesthesiologists physical status I–III. Clonidine (15 μg) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.

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“…There are different anticipated mechanisms of action of dexmedetomidine in peripheral nerve blocks. These predicted mechanisms are direct action on a peripheral nerve, diminution of the inflammatory response, analgesia centrally mediated and vasoconstrictive effects of α2Badrenoceptor mediated even though they do not completely explain the effectiveness of dexmedetomidine in peripheral nerve blockades [12].…”

Section: Time Of Measurementmentioning

confidence: 99%

Dexmedetomidine as an adjuvant to bupivacaine on combined posterior lumbar plexus and sciatic nerve blocks, is it effective?

Kamhawy

Ellilly

Yakout

2019

Egyptian Journal of Anaesthesia

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Background: Many drugs were added bupivacaine to extend the total time of analgesia in the postoperative period. Dexmedetomidine was a successful additive in neuraxial block. It provides stable hemodynamics and better and prolonged analgesia after surgery. By this present work, we aim to assess the role of added dexmedetomidine to bupivacaine during combined sciatic and posterior lumbar plexus blocks during femur surgery regarding period of sensory and motor blocks, efficacy of its analgesic effect and incidence of adverse effects. Methods: Our trial was done on 80 patients undergoing femur surgeries. They were all randomly chosen into two groups which have undergone combined sciatic nerve and posterior lumbar plexus blocks as solo anesthetic technique by peripheral nerve blocks. Group I: patients received bupivacaine 0.5% with no additives. Group II: patients received dexmedetomidine 100 µg with bupivacaine 0.5%. Results: Adding dexmedetomidine prolongs total duration of motor and sensory block significantly by more than twofold (p = 0.001) as well as it took shorter time to achieve loss of pinprick sensation and also a shorter time was required to reach modified Bromage scale grade IV. Patients in Group 1 requested analgesia earlier after surgery, as well as they had significantly higher morphine consumption postoperatively compared to those in Group II (p = 0.001). Conclusion: Adding of dexmedetomidine to the local anesthetic lessen the time till the beginning of the block and lengthen its total duration. It also prolongs analgesia postoperatively and has few side effects.

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Conduction Block by Clonidine Is Not Mediated by α2-Adrenergic Receptors in Rat Sciatic Nerve Fibers

Cited by 11 publications

References 17 publications

Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study

Addition of clonidine or lignocaine to ropivacaine for supraclavicular brachial plexus block: a comparative study

A comparison of analgesic efficacy and safety of clonidine and methylprednisolone as additives to 0.25% ropivacaine in stellate ganglion block for the treatment of complex regional pain syndrome: a prospective randomised single blind study

Dexmedetomidine as an adjuvant to bupivacaine on combined posterior lumbar plexus and sciatic nerve blocks, is it effective?

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