Hemodynamic and Analgesic Profile after Intrathecal Clonidine in Humans

Filos, Kriton S.; Goudas, Leonidas C.; Patroni, Ourania; Polyzou, V.

doi:10.1097/00000542-199409000-00011

Cited by 189 publications

(112 citation statements)

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“…Sedation, a central effect of α-2 adrenergigcs, may occur after either systemic, epidural or intrathecal administration of clonidine, 22,23 notably in the dose range of 150 to 450 µg. 11 However, in our study sedation is not observed in any of the patients in BC group, which also could be explained by the use of a low dose of intrathecal clonidine.…”

Section: Discussioncontrasting

confidence: 66%

“…11,20,21 However, as our results demonstrate, a small dose of intrathecal clonidine is not usually associated with systemic side effects, such as bradycardia, hypotension or sedation. 17 Relative hemodynamic stability was maintained in both groups.…”

Section: Discussionmentioning

confidence: 54%

“…According to some previous studies, intrathecal clonidine alone, even at doses above 450 µg, does not cause muscular weakness and motor blockade, 11 but combined with local anesthetics it significantly enhances the intensity and duration of motor blockade. 2,4 In our study, however, we found a significant difference in the TAMB between the two groups, in favour of the clonidine group, but we failed to achieve statistical significance in the duration of the motor block.…”

Section: Discussionmentioning

confidence: 92%

“…11 The aim of this prospective, randomized, double-blinded study was to evaluate the effects of clonidine in co-administration with bupivacaine during spinal anesthesia, regarding the onset and regression of motor block, sensory block, postoperative analgesia and possible side effects.…”

Section: Introductionmentioning

confidence: 99%

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Intrathecal clonidine added to small-dose bupivacaine prolongs

Gecaj-Gashi

Terziqi

Pervorfi

et al. 2013

CUAJ

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Introduction: The aim of this prospective, double-blinded study was to investigate the effects of clonidine in co-administration with bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects. Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I-II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 µg intrathecally. We performed the spinal anesthesia at a level of L3-L4 with a 25-gauge needle. We assessed the sensory block with a pinprick, the motor block using the Bromage scale, analgesia with the visual analog scale and sedation with the modified Wilson scale. We also recorded the hemodynamic and respiratory parameters. Results: The groups were demographically similar. The mean time of achievement of motor block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded. Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intrathecal clonidine added to small-dose bupivacaine prolongs

Gecaj-Gashi

Terziqi

Pervorfi

et al. 2013

CUAJ

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“…Significant bradycardia (HR <60beats/min) was treated with atropine sulphate 0.6mg intravenously. Sedation score was assessed with a four-point scale as per filos [16]: Awake and alert; Drowsy, responsive to verbal stimuli; Drowsy, arousable to physical stimuli; Unarousable.…”

Section: Preoperative Managementmentioning

confidence: 99%

Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

Attal¹,

Chhaya²,

Singh³

et al. 2015

Int J of Biomed & Adv Res

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Objectives: This study aimed to evaluate the relative efficacy of intravenously administered clonidine and tramadol for control of intraoperative shivering following spinal anaesthesia. Materials and Methods: A prospective, randomized, clinical controlled study was conducted on 60 ASA grade-I &II patients of either sex, aged 18-40 years, scheduled for elective lower abdominal and lower limb surgeries, under spinal anaesthesia. Patients who developed post spinal intraoperative shivering of grades 3 or 4, lasting for minimum period of 2minutes were included in the study, and randomly allocated to one of the two groups, group C (n=30), received Inj. clonidine 50µg i.v., and group T (n=30), received Inj. tramadol 50mg i.v. when shivering was observed. Time taken for control of shivering, response rate, recurrence rate, and side effects were observed. Results: The response rate was significantly higher in tramadol group than clonidine group at 1min, 2mins, and 3mins and 5mins intervals and comparable in both groups at 15 mins. The average time taken for disappearance of shivering was higher in clonidine group i.e. 5.76 ± 0.88mins as against 3.16 ± 0.84mins in tramadol group (P=0.038). Patients with incomplete response and recurrence were more in clonidine group. Side effects like hypotension, bradycardia, sedation and dry mouth were observed in clonidine group patients, and nausea and vomiting in tramadol group, but were controllable. Conclusion: Tramadol is better as compared to clonidine for control of intraoperative shivering under spinal anaesthesia due to rapid onset, higher response rate, lesser recurrence, lesser sedation and lesser hemodynamic alterations.

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α₂‐Agonists as analgesic agents

Giovannoni¹,

Ghelardini²,

Vergelli³

et al. 2008

Medicinal Research Reviews

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It is well known that norepinephrine is involved in the control of pain by modulating pain-related responses through various pathways. alpha(2)-Adrenergic agonists have a well-established analgesic profile and, in the recent years, have found a wider application, in particular as adjunct to anesthetics and analgesics in perioperative settings. This review analyzes the alpha(2)-agonists currently in clinical use, starting from the prototype Clonidine, as well as the most promising and studied molecules. In addition, an overview of the imidazoles, imidazolines, and hydroxyethyl-thioureas derivatives published in both the open and patented literature is presented, providing chemical description and pharmacological data. Finally, the most commonly alpha(2)-agonists used in veterinary medicine are described.

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Hemodynamic and Analgesic Profile after Intrathecal Clonidine in Humans

Cited by 189 publications

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Intrathecal clonidine added to small-dose bupivacaine prolongs

Intrathecal clonidine added to small-dose bupivacaine prolongs

Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

α₂‐Agonists as analgesic agents

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Hemodynamic and Analgesic Profile after Intrathecal Clonidine in Humans

Cited by 189 publications

References 0 publications

Intrathecal clonidine added to small-dose bupivacaine prolongs

Intrathecal clonidine added to small-dose bupivacaine prolongs

Comparison of clonidine and tramadol for the control of shivering under spinal anaesthesia

α2‐Agonists as analgesic agents

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α₂‐Agonists as analgesic agents