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KMID : 0356919950280050688
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Korean Journal of Anesthesiology
1995 Volume.28 No. 5 p.688 ~ p.693
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The Effects of Epidural Clonindine Added to Bupivacaine, Fentanyl and Epinephrine on the Pain control after Total Abdominal Hysterectomy
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Abstract
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Epidurally administered clonidine, a selective α2-adrenergic agonist, has been reported to produce postoperative analgesia.
The aim of this study was to see if the addition of a small dose of clonidine to a mixture of bupivacaine, fentanyl and epinephrine prolonged the duration of analgesia and reduce the number of injections or the total bupivacaine requirement and
the
incidence of side effects.
Forty patients presenting for TAH in ASA physical status 1 or 2. Were randomly divided into two groups: group 1 was given a 10 ml epidural solution of bupivacaine 12.5 mg combined with fentanyl 50 ㎍ and epinephrine 50㎍ ; group 2 was given the
same
solution with clonidine 75 ㎍.
Changes in the systolic and diastolic blood pressure and the pulse rate were recorded at 5, 10, 20, 30, 45, 60, 75, 90, 105 and 120 minutes after drug administration, and the analgesic effects were assessed by measuring pain score (Prince Henry
Score),
analgesic duration. Total bupivacaine requirement for 24 hours and side effect.
@ES The results were as follows:
@EN 1) Heart rate changed little in group 1 and decreased significantly in group 2.
2) Systolic and diastolic blood pressure decreased significantly in all groups (earlier in group 2 than in group 1).
3) The mean duration of analgesia was significantly prologed in group 2, compared with group 1 (437min in group 2: 229 min in group 1). For 24 hours after the first injection, numbers of injections (6 in group 1 ; 3.15 in group 2) and total
bupivacaine
requirements (75.0 mg in group 1 ; 39.1 mg in group 2) were significantly reduced.
5) The side effects including hypotension, nausea and vomiting, pruritus and respiratory depression were not significantly different from each other.
These results show that epidurally administered clonidine helps to prolong analgesic duration, and decreased need for supplemental bupivacaine, after lower abdominal surgery.
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KEYWORD
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