Journalartikel

Jahr der Veröffentlichung: 1998

Seiten: 565-570

Zeitschrift: Der Anaesthesist

Bandnummer: 47

Heftnummer: 7

ISSN: 0003-2417

DOI Link: https://doi.org/10.1007/s001010050597

Verlag: Springer

Abstract: 

Objective: The aim of this study was to investigate preliminarydose-range effects of clonidine added to ropivacaine for epidural analgesia in elective orthopedic surgery of the lower limbs with doses, causing a minimum of cardiovascular side effects.

Methods: 60 patients were randomly assigned to receive in a double-blind fashion a mixture of 1 mg/cm height ropivacaine plus saline or 7 mg/cm ropivacaine plus 25 mu g, 50 mu g, 75 mu g, 100 mu g or 150 mu g clonidine for epidural analgesia. The sensory and motor function were determined at defined time intervalls for 30 minutes. Heart rate and blood pressure were controlled and sedation score was judged. The postoperative 2-segment-regression of pin-prick and the onset of pain were recorded.

Results: The six groups were comparable in demographic datas and in term of onset time. The prolongation of analgesia reached 513 +/- 92 min (p = 0,002) for 150 mu g clonidine, 460 +/- 148 min (p = 0,073) for 100 mu g clonidine, 440 +/- 86 min (p = 0,057) for 75 mu g clonidine compared with 347 +/- 114 min for saline. In an equal manner, 2-segment-regression for pin-prick was extended to 251 +/- 47 min (p = 0,018) for 150 mu g clonidine, 238 +/- 33 min (p = 0,034) for 100 mu g clonidine, 229 +/- 29 min (p = 0,027) for 75 mu g clonidine and 178 +/- 43 min for saline. Heart rate dropped down in all groups. Mean arterial pressure decreased significantly in the groups with 75, 100 and 150 mu g clonidine. Sedation score increased continously from 0,6 +/- 0,5 (saline) to 1,8 +/- 0,8 (150 mu g clonidine).

Conclusion: We conclude that 150 mu g clonidine significantly enhances the duration of analgesia of epidurally administered ropivacaine in a mean of 171 mg. This time intervall is longer than the one with 200 mg ropivacaine alone. But, there are side effects in form of decrease of arterial pressure. Cardiovascular monitoring seems to be essential. Because of the enhanced analgesia duration,the time interval for reloading epidural anaesthesia are increased.

Harvard-Zitierstil: Engel, J., Hussmann, R., Gurtler, K., Menges, T. and Hempelmann, G. (1998) Dose-range effects of clonidine added to ropivacaine for epidural analgesia in orthopedic surgery, Der Anaesthesist, 47(7), pp. 565-570. https://doi.org/10.1007/s001010050597

APA-Zitierstil: Engel, J., Hussmann, R., Gurtler, K., Menges, T., & Hempelmann, G. (1998). Dose-range effects of clonidine added to ropivacaine for epidural analgesia in orthopedic surgery. Der Anaesthesist. 47(7), 565-570. https://doi.org/10.1007/s001010050597