Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: a volunteer study

被引:259
作者
Marhofer, D. [1 ]
Kettner, S. C. [1 ]
Marhofer, P. [1 ]
Pils, S. [2 ]
Weber, M. [2 ]
Zeitlinger, M. [2 ]
机构
[1] Med Univ Vienna, Dept Anaesthesia Intens Care Med & Pain Therapy, A-1090 Vienna, Austria
[2] Med Univ Vienna, Dept Clin Pharmacol, A-1090 Vienna, Austria
关键词
anaesthetic techniques; regional; brachial plexus; PERINEURAL DEXMEDETOMIDINE; POSTOPERATIVE ANALGESIA; ULTRASOUND GUIDANCE; RAT; CLONIDINE; DURATION; BUPIVACAINE; AGONISTS;
D O I
10.1093/bja/aes400
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
Dexmedetomidine is an -2-receptor agonist which might be used as an additive to local anaesthetics for various regional anaesthetic techniques. We therefore designed this prospective, double-blinded, controlled volunteer study to investigate the effects of dexmedetomidine as an adjuvant to ropivacaine on peripheral nerve block. Ultrasound-guided ulnar nerve block (UNB) was performed in 36 volunteers with either 3 ml ropivacaine 0.75 (R), 3 ml ropivacaine 0.75 plus 20 g dexmedetomidine (RpD), or 3 ml ropivacaine 0.75 plus systemic 20 g dexmedetomidine (RsD). UNB-related sensory and motor scores were evaluated. Sensory onset time of UNB was not different between the study groups, whereas motor onset time was significantly faster in Group RpD when compared with the other study groups [mean (sd)] [21 (15) vs 43 (25) min in Group RsD and 47 (36) min in Group R, P0.05 Group RpD vs other groups]. The duration of sensory block was 350 (54) min in Group R, 555 (118) min in Group RpD, and 395 (40) min in Group RsD (P0.01 Group RpD vs other groups, P0.05 Group RsD vs Group R). Motor block duration was similar to the duration of sensory block. A profound prolongation of UNB of approximate to 60 was detected with perineural dexmedetomidine when added to 0.75 ropivacaine. The systemic administration of 20 g dexmedetomidine resulted in a prolongation of approximate to 10 during UNB with 0.75 ropivacaine. Eudra-CT No.: 2012-000030-19.
引用
收藏
页码:438 / 442
页数:5
相关论文
共 17 条
[1]
Dexmedetomidine [J].
Bhana, N ;
Goa, KL ;
McClellan, KJ .
DRUGS, 2000, 59 (02) :263-268
[2]
Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat [J].
Brummett, Chad M. ;
Norat, Mary A. ;
Palmisano, John M. ;
Lydic, Ralph .
ANESTHESIOLOGY, 2008, 109 (03) :502-511
[3]
Perineural Dexmedetomidine Added to Ropivacaine for Sciatic Nerve Block in Rats Prolongs the Duration of Analgesia by Blocking the Hyperpolarization-activated Cation Current [J].
Brummett, Chad M. ;
Hong, Elizabeth K. ;
Janda, Allison M. ;
Amodeo, Francesco S. ;
Lydic, Ralph .
ANESTHESIOLOGY, 2011, 115 (04) :836-843
[4]
Perineural Dexmedetomidine Provides an Increased Duration of Analgesia to a Thermal Stimulus When Compared With a Systemic Control in a Rat Sciatic Nerve Block [J].
Brummett, Chad M. ;
Amodeo, Francesco S. ;
Janda, Allison M. ;
Padda, Amrita K. ;
Lydic, Ralph .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2010, 35 (05) :427-431
[5]
Perineural Dexmedetomidine Added to Ropivacaine Causes a Dose-dependent Increase in the Duration of Thermal Antinociception in Sciatic Nerve Block in Rat [J].
Brummett, Chad M. ;
Padda, Amrita K. ;
Amodeo, Francesco S. ;
Welch, Kathleen B. ;
Lydic, Ralph .
ANESTHESIOLOGY, 2009, 111 (05) :1111-1119
[6]
BUTTNER J, 1992, ANAESTHESIST, V41, P548
[7]
Small-dose clonidine prolongs postoperative analgesia after sciatic-femoral nerve block with 0.75% ropivacaine for foot surgery [J].
Casati, A ;
Magistris, L ;
Fanelli, G ;
Beccaria, P ;
Cappelleri, G ;
Aldegheri, G ;
Torri, G .
ANESTHESIA AND ANALGESIA, 2000, 91 (02) :388-392
[8]
Dexmedetomidine Added to Levobupivacaine Prolongs Axillary Brachial Plexus Block [J].
Esmaoglu, Aliye ;
Yegenoglu, Fusun ;
Akin, Aynur ;
Turk, Cemil Yildirim .
ANESTHESIA AND ANALGESIA, 2010, 111 (06) :1548-1551
[9]
GAUMANN DM, 1992, ANESTH ANALG, V74, P719
[10]
Continuous peripheral nerve blocks: state of the art [J].
Grossi, Paolo ;
Allegri, Massimo .
CURRENT OPINION IN ANESTHESIOLOGY, 2005, 18 (05) :522-526