Oral clonidine premedication does not prolong analgesia after herniorrhaphy under subarachnoid anesthesia

被引:9
作者
Ezri, T [1 ]
Szmuk, P [1 ]
Shklar, B [1 ]
Katz, J [1 ]
Geva, D [1 ]
机构
[1] Univ Texas, Sch Med, Dept Anesthesiol, Houston, TX 77030 USA
关键词
alpha-2-agonists : clonidine; anesthesia; subarachnoid; premedication; sympathetic nervous system;
D O I
10.1016/S0952-8180(98)00073-7
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Study Objective: To determine the effect of oral clonidine premedication on duration of sensory and motor block, postoperative analgesia hemodynamic stability, sedation, and respiratory parameters after subarachnoid anesthesia (SA). Design: Prospective, double blind, randomized, placebo-controlled study. Patients: 80 ASA physical status I patients were randomized into four equal groups to receive oral premedication with either clonidine 5 mcg/kg (C5), clonidine 2.5 mcg/kg (C2.5), diazepam 100 mcg/kg (D), or placebo (PL). Measurements and Main Results: The following parameters were measured: duration of motor and sensory block, requirement for postoperative analgesia; systolic (SBP), diastolic (DBP), and mean (MBP) blood pressures; heart rate (HR); sedation and anxiolysis scales; respiratory rate (RR); oxyhemoglobin saturation; and complications. (1) The duration of sensory and motor block did not differ significantly among the groups. (2) There were no differences in the time to first request for analgesia and in requirements for analgesia in the first 24 postoperative hours. (3) Clonidine premedication before SA did not produce episodes of significant hypotension. HR did not differ significantly among the groups. Baseline SEP was significantly higher (p = 0.037) in group PL than in groups C5 and C2.5. Three minutes after SA significant decrease in the following parameters was observed: SEP in group PL compared with the other three groups (p = 0.004), DBP in group PL vs. groups C5 and C2.5 (p = 0.002), and MBP in group PL vs. groups C5 and C2.5 (p = 0.003). (4) Sedation and anxiolysis were more pronounced (p = 0.0001) in groups C5 and C2.5 than in groups D and PL and in group C5 than in group C2.5. (5) RR was significantly lower (p = 0.0024) in group C5 than in groups D and PL. (6) Complications consisted of three episodes (15%) of bradycardia in the C5 group and two of bradypnea (10%) in the same group. Conclusions: In healthy patients, premedication with oral clonidine provided useful sedation and anxiolysis and stable hemodynamics, without prolongation of sensory and motor block. Side effects occurred only with clonidine 5 mcg/kg. Thus, a dose of 2.5 mcg/kg is recommended. (C) 1998 by Elsevier Science Inc.
引用
收藏
页码:474 / 481
页数:8
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