Contrasting Analgesic Action of the Intrathecal Kappa Agonist (U50–488h) in Visceral Pain Processing as Compared to Morphine and Clonidine

Harada, Yoshinori; Nishioka, Kengo; Kitahata, Luke M.; Collins, J. G.

doi:10.1097/00000542-199109001-00662

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“…Studies in animals have shown that clonidine enhanced pregnancyinduced analgesia may be antagonized by naloxone [20]. Other animal work suggests there is a morphine-clonidine interaction which is synergistic for visceral antinociception [25].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 0.125% Bupivacaine With 0.125% Bupivacaine and Clonidine as Extradural Analgesia in the First Stage of Labour

O'Meara

Gin

1993

British Journal of Anaesthesia

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We have studied 42 healthy parturients with singleton vertex pregnancies, who were in the first stage of labour and requesting extradural analgesia. They were allocated randomly in a double-blind fashion to receive either 0.125% bupivacaine plain or 0.125% bupivacaine with clonidine 120 micrograms. Efficacy of analgesia was evaluated using linear visual analogue scoring (VAS), sensory block was assessed using bilateral pinprick in the mid-clavicular line and sedation scored on a five-point scale. Maternal and fetal cardiovascular variables were measured every 2 min for 20 min, at 30 min and subsequently at 15-min intervals. The reduction in VAS was greater at all times in the bupivacaine-clonidine group (P < 0.01). The median (range) duration of analgesia was greater in the bupivacaine-clonidine group (114.5 (30-243) min) compared with the bupivacaine group (53 (30-100) min) (P < 0.001). Analgesia was associated with a reduction in arterial pressure in both groups, but there were no between-group differences. Maternal heart rate was less than baseline values at 30-90 min in the bupivacaine-clonidine group only. Sedation was greater in the bupivacaine-clonidine group, especially from 15 to 45 min (P < 0.01). There were no differences in fetal heart rate, mode of delivery or Apgar scores between the two groups.

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Section: Discussionmentioning

confidence: 99%