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      Transdermal nitroglycerine enhances the post-operative analgesic effect of intrathecal clonidine in abdominal hysterectomies

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          alpha(2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995).

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            A comparison of the hydrochloride and carbon dioxide salts of lidocaine and prilocaine in epidural analgesia.

             P Bromage (1964)
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              Postoperative pain relief following intrathecal bupivacaine combined with intrathecal or oral clonidine.

              The purpose of the present study was to evaluate the postoperative analgesic and adverse effects of equal doses of oral or intrathecal clonidine in spinal anaesthesia with bupivacaine plain. Forty-five ASA I-III orthopaedic patients scheduled for osteosynthesis of a traumatic femur fracture were randomised in a double-blind fashion to one of 3 groups. Patients received 15 mg of plain bupivacaine intrathecally (group B) or an intrathecal mixture of bupivacaine 15 mg and clonidine 150 mg (group CIT). In group CPO oral clonidine 150 mg was administered 60 min before intrathecal injection of bupivacaine 15 mg. Oral and intrathecal clonidine prolonged the time until the first request for analgesics, 313 +/- 29 and 337 +/- 29 min, respectively, vs. 236 +/- 27 min in group B (P < 0.01). The total 24- h PCA morphine dose was significantly lower in group CIT(19.3 +/- 1.3 mg) compared to groups B and CPO(33.4 +/- 2.0 and 31.2 +/- 3.1 mg). MAP was decreased significantly during the first hour after intrathecal clonidine(14%) and during the first 5 h after oral clonidine(14-19%). HR decreased in CIT during the 5th and 6th postoperative hours(7-9%) and during the first 2 h(9%) in CPO (P < 0.01). The degree of sedation was more pronounced in group CPO during the first 3 h. Four patients had pruritus in group B. Addition of intrathecal clonidine prolonged analgesia and decreased morphine consumption postoperatively more than oral clonidine. Hypotension was more pronounced after oral than after intrathecal clonidine. Intrathecal clonidine is therefore recommended.

                Author and article information

                Department of Anesthesiology, SMS Medical College, Jaipur, Rajasthan, India
                Author notes
                Address for correspondence: Dr. Mamta Khandelwal, A 7, Vaishali Nagar, Near Police Station, Jaipur, Rajasthan, India. E-mail: drmamtakhandelwal@
                Indian J Anaesth
                Indian J Anaesth
                Indian Journal of Anaesthesia
                Medknow Publications & Media Pvt Ltd (India )
                Jan-Feb 2012
                : 56
                : 1
                : 79-81
                Copyright: © Indian Journal of Anaesthesia

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Brief Communications

                Anesthesiology & Pain management


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