Ropivacaine With or Without Clonidine Improves Pediatric Tonsillectomy Pain

Giannoni, Carla M.; White, Sno E.; Enneking, F. Kayser; Morey, Timothy E.

doi:10.1001/archotol.127.10.1265

Cited by 100 publications

(90 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…a more local effect at the level of the injured perianal nerves. Both Gianonni et al 17 and Lavand'homme and Eisenach 18 have described the potent effects of peripheral administration of a mixture of local anesthetics and clonidine when injected close to injured nerves or nerve endings. Opioid medications added to local anesthetic solutions have also been shown capable of prolonging the duration of peripheral nerve blocks.…”

Section: Discussionmentioning

confidence: 99%

Nerve stimulator guided pudendal nerve blockversus general anesthesia for hemorrhoidectomy

Naja

El-Rajab

Al-Tannir

et al. 2006

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: A randomized clinical trial was undertaken to test the hypothesis that patients receiving a nerve stimulator guided pudendal nerve block for hemorrhoidectomy would experience more effective and prolonged postoperative analgesia and shorter hospital stay compared to patients receiving general anesthesia. Methods:This was a prospective randomized observer-blinded study. Following Ethics Committee approval and informed consent, 80 patients scheduled for hemorrhoidectomy were randomized to two groups of 40 patients each: general anesthesia alone, or nerve stimulator guided pudendal nerve block. Postoperative pain, the primary outcome variable of the study, was assessed by visual analogue scale scores at pre-determined intervals during the postoperative period. Analgesic consumption, time to return to normal activities, patients' and surgeons' satisfaction, and duration of hospital stay were recorded. Results:The guided pudendal nerve block group failed in three patients, requiring their conversion to general anesthesia. Otherwise, patients in the pudendal nerve block group experienced better postoperative pain relief at rest (P < 0.0001), on walking, sitting, and defecation (P < 0.001), reduced need for opioids (11/35 vs 32/37; P < 0.0001), a more rapid return to normal activities (7.2 vs 13.8 days; P < 0.0001) and also a shorter hospital stay (25/35 vs 3/37 outpatient cases; P < 0.0001) compared to the general anesthesia group. Pudendal nerve block was also associated with overall higher patient satisfaction compared to general anesthesia (30/35 vs 9/37; P < 0.0001). Conclusion:Nerve stimulator guided pudendal nerve block is associated with reduced postoperative pain, shortened hospital stay, and earlier return to normal activity compared to general anesthesia for hemorrhoidectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Nerve stimulator guided pudendal nerve blockversus general anesthesia for hemorrhoidectomy

Naja

El-Rajab

Al-Tannir

et al. 2006

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…[13][14][15] Various preclinical and clinical studies have reported that clonidine produces antinociception regardless of the route of administration (central or peripheral). [16][17][18][19] Topical administration of clonidine elicits antinociception by blocking the emerging pain signals at peripheral terminals through alpha 2 adrenoceptors without producing the undesirable central side effect observed after systemic administration. 20 In a dose response study, it was demonstrated that iv clonidine 3µg/kg was more effective than clonidine 2µg/kg for postoperative pain relief after hemilaminectomy, while clonidine 5µg/kg resulted in same analgesia with significant side effects.…”

Section: Introductionmentioning

confidence: 99%

Comparison of nebulized ketamine and ketamine with clonidine in postoperative sore throat

et al. 2017

View full text Add to dashboard Cite

Background: Postoperative sore throat (POST) consider a minor ailment in patients receiving general anesthesia with endotracheal intubation, seen in 21-65% cases but it causes significant distress and increases postoperative morbidity and patient dissatisfaction. This study was done to compare nebulized ketamine and ketamine with clonidine to treat POST.Methods: This was a prospective, randomized, double-blind control clinical study. After approval from institution ethical and scientific committee, study was conducted in between May 2015-April 2016. Written and informed consent was obtained from 100 patients of either sex aged between 20-65 years. ASA I-II, undergoing surgery in supine position lasting up to two hour. Patients were randomized into two groups Group K (n=50) nebulized with 50 mg ketamine (1cc) + 3cc NS =4cc, Group KC (n=50) nebulized with ketamine 50mg (1cc) + clonidine 150µg (1cc) + 2cc NS for 15 min, before general anaesthesia with endotracheal intubation. The POST and hemodynamic variable were monitored before nebulization, after nebulization, before induction, on arrival to PACU and at 4, 8, 12, 24 hours post operatively. POST was graded on 4 point scale (0-3).Results: Overall incidence of POST was 46% (Group K-40%, KC-6%). The Incidence and severity of POST were significantly attenuated in Group KC in comparison to Group K at 4 hours (P= 0.002), 8 hours (P=0.000), 12 hours (P= 0.000) and at 24 hours (P=0.000).Conclusions: Preoperative nebulization with clonidine and ketamine mixture compared to ketamine is more effective in dealing with postoperative sore throat with no adverse effects.

show abstract

“…Binding of α 2 agonists to adrenoceptors in the spinal cord produces analgesia (5). There are several studies that have reported about the use of clonidine, an α 2 agonist, for postoperative analgesia as an infiltration agent (6)(7)(8). Dexmedetomidine has eight times stronger α 2 agonist effects than clonidine and there are studies asserting that the intravenous, intramuscular, intrathecal, epidural, and perineural use of this agent enhances the anesthetic and analgesic effects.…”

Section: Introductionmentioning

confidence: 99%

The Analgesic Effects of Incisional Levobupivacaine with Dexmedetomidine after Total Abdominal Hysterectomy

Ülgey

Güneş²,

Bayram³

et al. 2015

Erciyes Med J

View full text Add to dashboard Cite

Objective: The purpose of this study was to assess the analgesic efficacy of dexmedetomidine added levobupivacaine applied into the wound site by infiltration in total abdominal hysterectomy. Materials and Methods:We studied 50 American Society of Anesthesiologists (ASA) physical status I-II patients scheduled for abdominal hysterectomy. The patients were randomized into two groups: infiltration of the surgical area with 0.25% levobupivacaine (40 mL) (Group L) or 0.25% levobupivacaine plus 2 mcg kg −1 dexmedetomidine (40 mL) (Group DL) 5 min before skin incision. After anesthesia induction, 5 min before surgical incision, 20 mL of the trial preparation (0.25% levobupivacaine or 0.25% levobupivacaine plus 2 mcg.kg −1 dexmedetomidine) was injected in the subcutaneus tissue along the marked line of skin incision. Another 20 mL of the same trial preparation was then infiltrated preperitoneally along the line of the planned incision of the peritoneum.Results: Total meperidine consumption was significantly lower in Group DL (p=0.003). The visual analog scale (VAS) values at resting were significantly lower at 0, 2, and 4 h (p=0.001, 0.001, and 0.003, respectively) in Group DL in the postoperative period. VAS values at coughing were lower in Group DL at postoperative 0, 2, 4, 6, and 12 h (p=0.001; 001; 0.003; 0.006; 0.008 respectively). The need for rescue analgesic was significantly high in Group L (p<0.001).Conclusion: Dexmedetomidine added to local anesthetic agent applied to the wound site reduced the analgesic consumption and improved the pain scores in total abdominal hysterectomy surgery.

show abstract

Ropivacaine With or Without Clonidine Improves Pediatric Tonsillectomy Pain

Abstract: Preincisional injection of ropivacaine with clonidine prior to tonsillectomy has a preemptive analgesic effect that outlasts the local anesthetic and decreases pain, opioid use, and the time to return to normal activity.

Cited by 100 publications

References 17 publications

Nerve stimulator guided pudendal nerve blockversus general anesthesia for hemorrhoidectomy

Nerve stimulator guided pudendal nerve blockversus general anesthesia for hemorrhoidectomy

Comparison of nebulized ketamine and ketamine with clonidine in postoperative sore throat

The Analgesic Effects of Incisional Levobupivacaine with Dexmedetomidine after Total Abdominal Hysterectomy

Contact Info

Product

Resources

About