Brachial plexus block with bupivacaine: effects of added alpha-adrenergic agonists: comparison between clonidine and epinephrine

Eledjam, J.J.; Deschodt, J.; Viel, E.; Lubrano, Jean F.; Charavel, Pierre; d’Athis, F.; Cailar, J. du

doi:10.1007/bf03036962

Cited by 120 publications

(84 citation statements)

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“…The clonidine dose was arbitrarily chosen based on previous studies. [9][10][11] Whether lower doses of clonidine can be used with ropivacaine, as with lidocaine, 8 without compromising efficacy of the block is to be determined. This would then reduce the potential for side effects, in particular when used for day-case procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Prolongation of analgesia and anesthesia with the addition of clonidine that was observed in this study has been seen in previous studies combining clonidine with other local anesthetics. 9 In some cases we may have underestimated the onset time for loss of motor power, as movement was restricted at the wrist or fingers because of pain and/or physical injury. Nevertheless, we noted that the motor block was profound, and the onset and duration was comparable with that of the sensory block.…”

Section: Discussionmentioning

confidence: 99%

“…8 Clonidine appears to be superior to epinephrine in enhancing the duration of plexus blockade with bupivacaine and may offer other advantages while avoiding the potential risks of epinephrine. 9,10 There are no previous reports on the effect of adding clonidine to ropivacaine.…”

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confidence: 99%

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Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

2000

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Purpose: To evaluate the effect of adding clonidine to ropivacaine, for axillary brachial plexus blockade, on the onset and duration of sensory and motor block and duration of analgesia.Methods: In a prospective randomised double blind placebo controlled study axillary brachial plexus blockade was performed in 50 patients using 40 ml ropivacaine 0.75 %. Group (A) had 150 µg clonidine and Group (B) 1 ml normal saline added to the local anesthetic. Sensory function was tested using pinprick (sharp sensation, blunt sensation or no sensation) and temperature with an ice cube compared with the opposite arm, (cold/not cold). Motor function was assessed using a modified Bromage scale. Postoperative analgesia was standardised. Onset and duration of sensory and motor blockade, duration of analgesia, postoperative pain score, and analgesic requirement were compared. Results:The clonidine patients showed an increase in duration of sensory loss from 489 min to 628 min with a mean difference of 138 min (95% confidence interval of 90 to 187 min), motor blockade from 552 min to 721 min with a mean difference of 170 min (95% confidence interval of 117 to 222 min), and analgesia from 587 min to 828 min with mean difference of 241 min (95% confidence interval of 188 to 294 min). There was no difference in onset time. No side effects were noted. Conclusion:The addition of 150 µg of clonidine to ropivacaine, for brachial plexus blockade, prolongs motor and sensory block and analgesia, without an increased incidence of side effects.Objectif : Évaluer l'effet d'un ajout de clonidine à la ropivacaïne, pour le blocage du plexus brachial axillaire, sur le délai d'installation et la durée du bloc sensitif et moteur et sur la durée de l'analgésie.Méthode : Il s'agit d'une étude prospective, randomisée et à double insu contre placebo. Un blocage du plexus brachial axillaire a été réalisé chez 50 patients en utilisant 40 ml de ropivacaïne à 0,75 %. On a ajouté à l'anesthésique local, 150 µg de clonidine pour les patients du groupe A et 1 ml de solution salée pour ceux du groupe B. La fonction sensitive a été testée par piqûre d'épingle (sensation vive, légère sensation ou insensibilité) et la température par un cube de glace posé en alternance sur les deux bras (froid, non froid). La fonction motrice a été évaluée avec une échelle de Bromage modifiée. L'analgésie postopératoire a été normalisée. On a comparé le délai d'installation et la durée du blocage sensitif et moteur, la durée de l'analgésie, le score de douleur postopératoire et les besoins analgésiques.Résultats : Chez les patients qui ont reçu de la clonidine, on a noté une perte sensitive de plus longue durée, de 489 min à 628 min avec une différence moyenne de 138 min (intervalle de confiance de 95 %, de 90 à 187 min), un blocage moteur plus long de 552 min à 721 min avec une différence moyenne de 170 min (IC de 95 %, de 117 à 222 min) et une meilleure analgésie de 587 min à 828 min avec une différence moyenne de 241 min (IC de 95 %, de 188 à 294 min). Il n'y a pas eu de différen...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

2000

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“…have beneficial effects and several agents have been suggested. 1,2,3,4,5,6 Clonidine is an α agonist with partial action on α-2 receptors and is being used as a centrally acting antihypertensive agent. The addition of clonidine as an adjuvant to local anesthetics has beenreported to prolong the duration of analgesia and motor block.…”

Section: Introductionmentioning

confidence: 99%

Clonidine as an Adjuvant to 0.5% Ropivacaine for Supraclavicular Brachial Plexus Block in Patients Undergoing Orthopedic Surgery of Forearm and Hand - A Randomized Controlled Trial

Vikraman¹

2017

jmscr

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“…We also observed the mean duration of sensory block was significantly higher (P < 0.001) in group D. McCartney et al 12 found that a bupivacaine and clonidine combination prolonged postoperative analgesia compared to bupivacaine alone when administered for various peripheral nerve blocks. Eledjam J.J et al 13 , showed clonidine is an attractive alternative to epinephrine to prolong duration of analgesia in supraclavicular brachial plexus block. Esmaoglu A et al 14 showed, dexmedetomidine added to levobupivacaine for axillary brachial plexus block shortens the onset time and prolongs the duration of the block and the duration of postoperative analgesia.…”

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confidence: 99%

Comparative Study Between Dexmedetomidine and Clonidine as an Adjunct to Bupivacaine in Brachial Plexus Block in Orthopaedic Surgeries

Kakad¹,

Chaudhari²,

Lawhale³

et al. 2015

J Cont Med A Dent

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Brachial plexus block with bupivacaine: effects of added alpha-adrenergic agonists: comparison between clonidine and epinephrine

Cited by 120 publications

References 44 publications

Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

Clonidine as an Adjuvant to 0.5% Ropivacaine for Supraclavicular Brachial Plexus Block in Patients Undergoing Orthopedic Surgery of Forearm and Hand - A Randomized Controlled Trial

Comparative Study Between Dexmedetomidine and Clonidine as an Adjunct to Bupivacaine in Brachial Plexus Block in Orthopaedic Surgeries

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