Abstract
The effects of clonidine and epinephrine, administered into the brachial plexus sheath, were evaluated in 60 patients who underwent surgery of the upper limb. All patients received 40 to 50 ml of 0.25% bupivacaine, injected into the brachial plexus sheath, using the supraclavicular technique. The patients were randomly allocated to two groups so that 30 patients received 150 μg clonidine hydrochloride (Group I), and 30 received 200 μg epinephrine (Group II). The quality and the duration of analgesia were assessed as well as, the possible side-effects. The block produced with the addition of clonidine was longer (994.2±34.2 vs 728.3±35.8 min) and superior to that with epinephrine (P<0.001). No major side-effects were recorded. We conclude that the injection of clonidine into the brachial plexus sheath is an attractive alternative to epinephrine to prolong the duration of analgesia following upper limb surgery under conduction anaesthesia.
Résumé
Les effets de l’addition d’agents agonistes alpha-adrénergiques à la bupivacaïne lors de blocs du plexus brachial ont été évalués chez soixante patients ayant une intervention chirurgicale sur le membre supérieur. L’ensemble des patients a reçu 40 à 50 ml de bupivacaïne à 0.25% pour réaliser un bloc du plexus brachial par voie sus-claviculaire. Les patients du groupe I (n=30) recevaient par la même voie 150 μg de clonidine, ceux du groupe II (n=30) 200 μg d’ adrénaline. La durée et la qualité de l’analgésie sont ensuite étudiées ainsi que les éventuels effets adverses. Une différence statistiquement significative a été retrouvée en ce qui concerne la durée d’analgésie qui était supérieure dans le groupe clonidine (994,2±34,2 min vs 728,3 ±35,8 min; P<0.001). Aucun effet adverse majeur n’est retrouvé. Les auteurs concluent à l’intérêt particulier de la clonidine pour prolonger la durée d’ analgésie après chirurgie du membre supérieur réalisée sous anesthésie régionale.
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Eledjam, J.J., Deschodt, J., Viel, E.J. et al. Brachial plexus block with bupivacaine: effects of added alpha-adrenergic agonists: comparison between clonidine and epinephrine. Can J Anaesth 38, 870–875 (1991). https://doi.org/10.1007/BF03036962
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DOI: https://doi.org/10.1007/BF03036962