Efecto de dosis bajas de dexmedetomidina o clonidina sobre las características de la raquia con bupivacaína
Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block.
Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS.
Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon. gk05@aub.edu.lb
Acta Anaesthesiol Scand. 2006 Feb;50(2):222-7.
Abstract
BACKGROUND:The purpose of this study was to compare the onset and duration of sensory and motor block, as well as the hemodynamic changes and level of sedation, following intrathecal bupivacaine supplemented with either dexmedetomidine or clonidine.
METHODS:In a prospective, double-blind study, 60 patients undergoing transurethral resection of prostate or bladder tumor under spinal anesthesia were randomly allocated to one of three groups. Group B received 12 mg of hyperbaric bupivacaine, group D received 12 mg of bupivacaine supplemented with 3 microg of dexmedetomidine and group C received 12 mg of bupivacaine supplemented with 30 microg of clonidine. The onset times to reach peak sensory and motor levels, and the sensory and motor regression times, were recorded. Hemodynamic changes and the level of sedation were also recorded.RESULTS:Patients in groups D and C had a significantly shorter onset time of motor block and significantly longer sensory and motor regression times than patients in group B. The mean time of sensory regression to the S1 segment was 303 +/- 75 min in group D, 272 +/- 38 min in group C and 190 +/- 48 min in group B (B vs. D and B vs. C, P < 0.001). The regression of motor block to Bromage 0 was 250 +/- 76 min in group D, 216 +/- 35 min in group C and 163 +/- 47 min in group B (B vs. D and B vs. C, P < 0.001). The onset and regression times were not significantly different between groups D and C. The mean arterial pressure, heart rate and level of sedation were similar in the three groups intra-operatively and post-operatively. CONCLUSIONS:Dexmedetomidine (3 microg) or clonidine (30 microg), when added to intrathecal bupivacaine, produces a similar prolongation in the duration of the motor and sensory block with preserved hemodynamic stability and lack of sedation.
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2006.00919.x/pdf
Evaluación de los efectos analgésicos de clonidina intratecal junto con bupivacaína en cesárea
Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section.Kothari N, Bogra J, Chaudhary AK.
Department of Anesthesiology, CSMMU (erstwhile KGMC), Lucknow, Uttar Pradesh, India.
Saudi J Anaesth. 2011 Jan;5(1):31-5. doi: 10.4103/1658-354X.76499.
Abstract
AIMS AND CONTEXT: The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia. SETTINGS AND DESIGN:Randomized single blind trial.METHODS:210 ASA I-II pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I (n=70) patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group II (n=70) patients received intrathecal mixture of 0.5% hyperbaric bupivacaine (8 mg) and clonidine 50 μg. In group III (n=70), patients received 0.5% hyperbaric bupivacaine (10 mg) intrathecally along with 50 μg of clonidine. STATISTICAL ANALYSIS USED:Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test (χ(2) =57.2410). RESULTS:On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21±5.15 min. (group II) vs 146.0±4.55 min (group I), P=0.021; 95% confidence interval: 238.01-257.40, group II and 134.99-157.0 group I]. CONCLUSIONS: Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief.
KEYWORDS:Cesarean section, bupivacaine, intrathecal clonidine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101750/
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2011;volume=5;issue=1;spage=31;epage=35;aulast=Kothari;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block.
Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS.
Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon. gk05@aub.edu.lb
Acta Anaesthesiol Scand. 2006 Feb;50(2):222-7.
Abstract
BACKGROUND:The purpose of this study was to compare the onset and duration of sensory and motor block, as well as the hemodynamic changes and level of sedation, following intrathecal bupivacaine supplemented with either dexmedetomidine or clonidine.
METHODS:In a prospective, double-blind study, 60 patients undergoing transurethral resection of prostate or bladder tumor under spinal anesthesia were randomly allocated to one of three groups. Group B received 12 mg of hyperbaric bupivacaine, group D received 12 mg of bupivacaine supplemented with 3 microg of dexmedetomidine and group C received 12 mg of bupivacaine supplemented with 30 microg of clonidine. The onset times to reach peak sensory and motor levels, and the sensory and motor regression times, were recorded. Hemodynamic changes and the level of sedation were also recorded.RESULTS:Patients in groups D and C had a significantly shorter onset time of motor block and significantly longer sensory and motor regression times than patients in group B. The mean time of sensory regression to the S1 segment was 303 +/- 75 min in group D, 272 +/- 38 min in group C and 190 +/- 48 min in group B (B vs. D and B vs. C, P < 0.001). The regression of motor block to Bromage 0 was 250 +/- 76 min in group D, 216 +/- 35 min in group C and 163 +/- 47 min in group B (B vs. D and B vs. C, P < 0.001). The onset and regression times were not significantly different between groups D and C. The mean arterial pressure, heart rate and level of sedation were similar in the three groups intra-operatively and post-operatively. CONCLUSIONS:Dexmedetomidine (3 microg) or clonidine (30 microg), when added to intrathecal bupivacaine, produces a similar prolongation in the duration of the motor and sensory block with preserved hemodynamic stability and lack of sedation.
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2006.00919.x/pdf
Evaluación de los efectos analgésicos de clonidina intratecal junto con bupivacaína en cesárea
Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section.Kothari N, Bogra J, Chaudhary AK.
Department of Anesthesiology, CSMMU (erstwhile KGMC), Lucknow, Uttar Pradesh, India.
Saudi J Anaesth. 2011 Jan;5(1):31-5. doi: 10.4103/1658-354X.76499.
Abstract
AIMS AND CONTEXT: The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia. SETTINGS AND DESIGN:Randomized single blind trial.METHODS:210 ASA I-II pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I (n=70) patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group II (n=70) patients received intrathecal mixture of 0.5% hyperbaric bupivacaine (8 mg) and clonidine 50 μg. In group III (n=70), patients received 0.5% hyperbaric bupivacaine (10 mg) intrathecally along with 50 μg of clonidine. STATISTICAL ANALYSIS USED:Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test (χ(2) =57.2410). RESULTS:On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21±5.15 min. (group II) vs 146.0±4.55 min (group I), P=0.021; 95% confidence interval: 238.01-257.40, group II and 134.99-157.0 group I]. CONCLUSIONS: Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief.
KEYWORDS:Cesarean section, bupivacaine, intrathecal clonidine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101750/
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2011;volume=5;issue=1;spage=31;epage=35;aulast=Kothari;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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