Dose-Related Prolongation of Hyperbaric Tetracaine Spinal Anesthesia by Clonidine in Humans

Bonnet, Francis; Brun-Buisson, V.; Saada, M.; Boico, O.; Rostaing, S.; Touboul, C.

doi:10.1213/00000539-198905000-00014

Cited by 87 publications

(47 citation statements)

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“…This effect would possibly be related to a higher side-effect rate shown by some authors 13 , but not confirmed by this study or by other authors 3,6 . As to analgesic and motor block onset, our results are in line with other studies 12,13,29,30 , which obtained similar results with spinal clonidine. Clonidine's hemodynamic effects, usually hypotension and bradycardia, result from the activation of a 2 pre-synaptic receptors of peripheral nervous terminations, as well as from its action on brain stem and spinal cord, decreasing sympathetic outflow 1,14,33,34 .…”

Section: Discussionsupporting

confidence: 93%

“…Os resultados obtidos neste estudo com relação ao início de ação do bloqueio analgésico e motor estão de acordo com outros estudos 12,13,29,30 que obtiveram resultados semelhantes com o uso subaracnóideo de clonidina. Os efeitos hemodinâmicos da clonidina, geralmente hipotensão e bradicardia, resultam da ativação dos receptores a 2 pré-sinápticos das terminações nervosas periféricas e por efeito sobre o tronco cerebral e medula espinhal, diminuindo a saída do fluxo simpático 1, 14,33,34 .…”

Section: Métodounclassified

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Efeito da clonidina associada à bupivacaína a 0,5% hiperbárica na anestesia subaracnóidea

Fonseca¹,

Oliveira²

2001

Rev. Bras. Anestesiol.

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Section: Discussionsupporting

confidence: 93%

Section: Métodounclassified

Efeito da clonidina associada à bupivacaína a 0,5% hiperbárica na anestesia subaracnóidea

Fonseca¹,

Oliveira²

2001

Rev. Bras. Anestesiol.

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“…DXM when used intravenously during anesthesia reduces opioid and inhalational anesthetics requirements [21,22] . Compared with clonidine a 2-adrenoreceptor agonist, the affinity of DXM to 2 receptors has been reported to be 10 times more than clonidine [23] , moreover, Kalso et al [5] and Post et al [24] reported a 1:10 dose ratio between intrathecal DXM and clonidine in animals. Clinical studies in surgical patients showed that intrathecal clonidine increases the duration of sensory and motor spinal block when added to spinal local anesthetics and this effect of clonidine is dose-dependent [25][26][27] , and doses of more than 75 µg intrathecal clonidine is accompanied by excessive sedation, hypotension and bradycardia.…”

Section: Discussionmentioning

confidence: 99%

Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study

Al-Ghanem¹

2009

American Journal of Applied Sciences

122

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Problem statement:The purpose of this study was to evaluate the onset and duration of sensory and motor block as well as operative analgesia and adverse effects of Dex Metedo Midine (DXM) or fentanyl given intrathecally with plain 0.5% bupivacaine for spinal anesthesia. Approach: seventy six patients classified as American Society of Anesthesiologists (ASA) status I, II and III scheduled for vaginal hysterectomy, vaginal wall repair and tension free vaginal tape were prospectively studied. Patients were randomly allocated to receive intrathecally either 10 mg isobaric bupivacaine plus 5 µg dexmetedomidine (group D n = 38) or 10 mg isobaric bupivacaine plus 25 mg fentanyl (group F n = 38), the onset time to reach peak sensory and motor level, the regression time for sensory and motor block, hemodynamic changes, and side effects were recorded. Results: Patients in group D had significant longer sensory and motor block times than patients in group F. the mean time of sensory regression to S1 was 274±73 min in group D and 179±47 min in group F (P < 0.001). The regression time of motor block to reach modified Bromage 0 was 240±60 min in group D and 155±46 min in group F (P< 0.001). The onset times to reach T10 dermatome and to reach peak sensory level as well as onset time to reach modified Bromage 3 motor block were not significantly different between the two groups. Conclusion: In women undergoing vaginal reconstructive surgery under spinal analgesia, 10 mg plain bupivacaine supplemented with 5 µg dexmetedomidine produces prolonged motor and sensory block compared with 25 µg fentanyl.

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“…Obtaining written informed consent from each subject, 120 healthy subjects of either sex, aged 20 -50 years, ASA physical status I & II scheduled for elective lower abdominal surgery under spinal anaesthesia were selected. They were randomly divided into four equal groups (Group B, BC 15 , BC 30 and BC 45 ) by a computerized randomization chart (n = 30). Groups BC 15 , BC 30, and BC 45 received mixture of 10 mg hyperbaric bupivacaine plus clonidine in the doses of 15, 30, and 45 µg respectively intrathecally.…”

Section: Methodsmentioning

confidence: 99%

Intrathecal Clonidine Co-Administered With Hyperbaric Bupivacaine in Infra-Umbilical Surgery - A Dose Response Study

Mandal¹,

Biswas²,

Mondal³

et al. 2016

AIMDR

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Background: Clonidine, the α2 -adrenergic agonist, has a variety of different action including the ability to potentiate the effect of local anaesthetic without any significant undesirable effects. The intrathecal use of different doses of clonidine when co-administered with hyperbaric bupivacaine provides prolongation of pain free period than hyperbaric bupivacaine alone. Objectives: Our present study was targeted to find out the optimum intrathecal dose of clonidine as an adjunct to hyperbaric bupivacaine.Methods: Patients with ASA physical status I & II scheduled for elective infra umbilical surgery under spinal anaesthesia were randomly divided into four equal groups (n = 30) by a computerized randomization chart. Groups BC15, BC30, and BC45 received mixture of 10 mg hyperbaric bupivacaine plus clonidine in the doses of 15, 30, and 45 µg respectively intrathecally and the control group (Group B) received 0.5% hyperbaric bupivacaine 10 mg and normal saline as placebo. All analysis was two tailed and P value < 0.05 was considered statistically significant. Data analyzed with the help SPSS software version 16.0 for Windows, SPSS Inc. Chicago. Results: It was observed that intrathecal clonidine to hyperbaric bupivacaine dose dependently prolongs both sensory blockade of spinal anesthesia and time to request for first supplemental analgesia in post operative period. Conclusion: Because of the absence of significant adverse effects, we conclude that, within the tested dose range, 30 µg of clonidine is the preferred dose, when prolongation of spinal anesthesia is desired.

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Dose-Related Prolongation of Hyperbaric Tetracaine Spinal Anesthesia by Clonidine in Humans

Cited by 87 publications

References 0 publications

Efeito da clonidina associada à bupivacaína a 0,5% hiperbárica na anestesia subaracnóidea

Efeito da clonidina associada à bupivacaína a 0,5% hiperbárica na anestesia subaracnóidea

Effect of Adding Dexmedetomidine versus Fentanyl to Intrathecal Bupivacaine on Spinal Block Characteristics in Gynecological Procedures: A Double Blind Controlled Study

Intrathecal Clonidine Co-Administered With Hyperbaric Bupivacaine in Infra-Umbilical Surgery - A Dose Response Study

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