Anesthesia and analgesia · 2009
The analgesic effect of epidural clonidine after spinal surgery: a randomized placebo-controlled trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Farmery Andrew D, Wilson-MacDonald James
Аннотация
BACKGROUND: Clonidine is an alpha(2) adrenoreceptor and imidazoline receptor agonist, which has analgesic, sedative, and minimum alveolar anesthetic concentration-sparing effects. It has been used orally, IV, and epidurally. In spinal surgery, there is a reluctance to use local anesthetic-based epidural analgesia postoperatively because of fears of masking important signs of nerve root or spinal cord injury.
METHODS: We randomized 66 patients undergoing uncomplicated decompressive spinal surgery to receive an epidural infusion of either clonidine (Group C) or saline placebo (Group P) postoperatively. Morphine consumption by patient-controlled analgesia device was recorded for 36 h.
RESULTS: Morphine consumption was significantly lower in Group C. The mean consumption at 36 h was 35 mg (95% confidence interval 21-50 mg) in Group C, compared with 61 mg (95% confidence interval 48-74 mg) in the control group. Nausea was significantly reduced in Group C (6.5%), when compared with placebo (38.2%).
CONCLUSION: Low-dose epidural clonidine significantly reduced the demand for morphine and reduced postoperative nausea with few side effects.
METHODS: We randomized 66 patients undergoing uncomplicated decompressive spinal surgery to receive an epidural infusion of either clonidine (Group C) or saline placebo (Group P) postoperatively. Morphine consumption by patient-controlled analgesia device was recorded for 36 h.
RESULTS: Morphine consumption was significantly lower in Group C. The mean consumption at 36 h was 35 mg (95% confidence interval 21-50 mg) in Group C, compared with 61 mg (95% confidence interval 48-74 mg) in the control group. Nausea was significantly reduced in Group C (6.5%), when compared with placebo (38.2%).
CONCLUSION: Low-dose epidural clonidine significantly reduced the demand for morphine and reduced postoperative nausea with few side effects.
Предметные рубрики MeSH
Adrenergic alpha-AgonistsAdultAgedAnalgesia, EpiduralBlood PressureClonidineDouble-Blind MethodFemaleHeart RateHumansHypnotics and SedativesLinear ModelsMaleMiddle AgedMorphinePain MeasurementPostoperative PainPilot ProjectsPostoperative Nausea and VomitingPreanesthetic MedicationSpineUrinary Retention