Clonidine Added to the Anesthetic Solution Enhances Analgesia and Improves Oxygenation After Intercostal Nerve Block for Thoracotomy

Tschernko, Edda; Klepetko, Heike; Gruber, Éva; Kritzinger, Meinhard; Klimscha, Walter; Jandrasits, Oliver; Haider, W.

doi:10.1213/00000539-199807000-00023

Cited by 32 publications

(24 citation statements)

References 18 publications

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“…Some clinical studies have also shown that clonidine added to local anaesthetics in brachial plexus [18] and intercostal nerve [19] blocks, prolongs the duration and quality of anaesthesia and analgesia. These effects were not noticed when clonidine was given systemically and therefore appears to be attributable to a local inhibitory effect on the neuronal transmission [18,19]. Although alpha 2-receptors have been isolated on peripheral nerves in rats [20], it is probable that other mechanisms are involved [21].…”

Section: Discussionmentioning

confidence: 99%

Fentanyl and clonidine as adjunctive analgesics with levobupivacaine in paravertebral analgesia for breast surgery

Burlacu¹,

Frizelle

Moriarty

et al. 2006

Anaesthesia

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SummaryThe addition of fentanyl or clonidine to levobupivacaine was evaluated in patients undergoing breast surgery under general anaesthesia with intra-and postoperative paravertebral analgesia. Patients were randomly allocated to four groups: Group L received 19 ml bolus levobupivacaine 0.25% plus 1 ml saline followed by an infusion of levobupivacaine 0.1%; Group LF received 19 ml bolus levobupivacaine 0.25% plus fentanyl 50 lg followed by an infusion of levobupivacaine 0.05% with fentanyl 4 lg.ml )1 ; Group LC received 19 ml bolus levobupivacaine 0.25% plus clonidine 150 lg followed by an infusion of levobupivacaine 0.05% with clonidine 3 lg.ml

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Section: Discussionmentioning

confidence: 99%

Fentanyl and clonidine as adjunctive analgesics with levobupivacaine in paravertebral analgesia for breast surgery

Burlacu¹,

Frizelle

Moriarty

et al. 2006

Anaesthesia

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“…This has been demonstrated in previous reports following coadministration with other cationic drugs such as propranolol and paracetamol which enhance free lidocaine concentration in serum and tissues (10,11). After clonidine treatment a time dependent high serum value of lidocaine free fraction was observed (12). On the other hand many studies have been focused on the pharmacodynamic interaction of both drugs.…”

Section: Discussionmentioning

confidence: 99%

Clonidine changes lidocaine free concentrations in rat myocardium without affecting heart function measured by echocardiography

Tigka

Kotsiou

Saranteas

et al. 2009

Eur. J. Drug Metabol. Pharmacokinet.

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Lidocaine is a local anaesthetic widely used in regional and epidural anaesthesia. Clonidine a alpha2-adrenergic agonist is an antihypertensive agent, regulating the production of catecholamines (epinephrine and norepinephrine) and added to local anesthetic infusions in order to improve postoperative analgesia. The aim of the study was to investigate the influence of clonidine co-administration on the binding of 14C lidocaine to rat serum and heart tissue protein as well as its pharmacodynamic effects in the heart. Four groups of Wistar rats (n=7) were used; Groups I and II received 4 mg/kg lidocaine i.m. Groups III and IV received lidocaine and 1 microg/kg clonidine i.m. In group I and III fifteen minutes and in groups II and IV thirty minutes after the initial treatment, ultrasound examination of heart function (heart rate, diameter of left ventricle in systole and diastole, ejection fraction) was performed. The animals were then sacrificed in all groups. Lidocaine free fraction in serum and heart was evaluated via ultrafiltration. The kinetics of lidocaine was altered by clonidine co-administration probably by mechanisms related to protein binding alterations. However, the pharmacokinetic interactions were not accompanied by changes of pharmacodynamic parameters including those of heart function as measured by echocardiography.

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“…For example, when combined with lidocaine in axillary brachial plexus block, fentanyl increased the success rate and prolonged the dura-tion of the sensory blockade, an effect that was not shown when fentanyl was given intravenously or placebo was added to local anesthetic. 20 Similarly, clonidine added to local anesthetic in peripheral administration, notably brachial plexus 4 and intercostal nerve block, 21 prolong the duration and quality of anesthesia and analgesia. These effects were not noticed when clonidine was given systemically (i.e., subcutaneously and intramuscularly) rather than in a mixture with local anesthetic and therefore appears to be attributable to a local inhibitory effect on the neuronal transmission.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of Levobupivacaine, Fentanyl, and Clonidine After Administration in Thoracic Paravertebral Analgesia

Burlacu

Frizelle

Moriarty

et al. 2007

Regional Anesthesia and Pain Medicine

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Clonidine Added to the Anesthetic Solution Enhances Analgesia and Improves Oxygenation After Intercostal Nerve Block for Thoracotomy

Cited by 32 publications

References 18 publications

Fentanyl and clonidine as adjunctive analgesics with levobupivacaine in paravertebral analgesia for breast surgery

Fentanyl and clonidine as adjunctive analgesics with levobupivacaine in paravertebral analgesia for breast surgery

Clonidine changes lidocaine free concentrations in rat myocardium without affecting heart function measured by echocardiography

Pharmacokinetics of Levobupivacaine, Fentanyl, and Clonidine After Administration in Thoracic Paravertebral Analgesia

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