Clonidine does not improve quality of ropivacaine axillary brachial plexus block in children

Trifa, Mehdi; Khalifa, S. Ben; Jendoubi, Ali; Zribi, Najeh; Regaya, T.; Engelhardt, Thomas

doi:10.1111/j.1460-9592.2012.03809.x

Cited by 27 publications

(14 citation statements)

References 29 publications

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“…Moreover, pain control is challenging in these painful hand surgery procedures. As described for non‐EB patients , we could show that APB provides good and long‐lasting postoperative analgesia.…”

Section: Discussionsupporting

confidence: 65%

Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

Heuvel

Gottschalk

Langer

et al. 2016

Pediatric Anesthesia

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Section: Discussionsupporting

confidence: 65%

Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

Heuvel

Gottschalk

Langer

et al. 2016

Pediatric Anesthesia

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“…We chose bupivacaine because controversy still exists about using clonidine as an adjuvant to long-acting LA such as ropivacaine and bupivacaine where in some studies support its addition to peripheral nerve block,[91112] while others contradict it. [4131516]…”

Section: Discussionmentioning

confidence: 99%

Brachial plexus block: Comparison of two different doses of clonidine added to bupivacaine

Kohli

Kaur

Sahoo

et al. 2013

J Anaesthesiol Clin Pharmacol

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Background:The role of clonidine as an adjuvant to local anesthetic agents in brachial plexus block (BPB) has been extensively studied. However, till date there has been no consensus about the ideal dose of clonidine for this purpose. This study was carried out to evaluate two doses of clonidine-1 and 2 g/kg, added to 0.5% bupivacaine, with regard to onset and duration of sensorimotor blockade, hemodynamic effects, postoperative analgesia, and adverse effects.Materials and Methods:Sixty adult patients undergoing upper limb surgeries were randomly allocated into two groups. Thirty patients received 1 g/kg clonidine (group I) and the rest received 2 g/kg clonidine (group II) added to 30 mL of 0.5% bupivacaine through nerve stimulator-guided supraclavicular BPB. The onset and duration of sensorimotor blockade, hemodynamic variables, duration of analgesia, level of sedation, and adverse effects was assessed.Results:The onset of sensorimotor block was earlier in group II (9.9 ± 4.1 min for sensory block and 13.2 ± 6.7 min for motor block) than in group I (15.9 ± 6.8 min for sensory block and 18.5 ± 7.8 min for motor block). The duration of analgesia was also prolonged in patients receiving the higher dose (21.0 ± 2.96 h vs. 14.9 ± 3.0 h). Although hemodynamics remained comparable in both the groups, incidence of hypotension and bradycardia was higher in group II as compared to group I. The sedation was clinically and statistically more in group II patients (43% vs. 17%).Conclusion:Higher dose of clonidine in BPB hastens the onset, prolongs the duration of sensorimotor blockade and postoperative analgesia without significant hemodynamic alterations. It also causes more sedation, which although ensures patient comfort in most cases, but might be undesirable in certain situations.

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“…The findings in this small study are similar to those of previous trials using clonidine as an adjunct to local anesthetics in ilioinguinal–iliohypogastric and axillary brachial plexus blocks. The lack of statistically significant difference could potentially be explained through the lack of alpha 2‐adrenergic receptors in peripheral nerves . However, Cucchiaro and Ganesh found that clonidine increased the duration of sensory block when added to long‐acting local anesthetics suggesting potential benefits .…”

mentioning

confidence: 99%

“…In conclusion, this small study indicates that the addition of clonidine to 0.25% bupivacaine may not improve the quality of analgesia or increase the duration of analgesia in saphenous/sciatic nerve blocks for foot surgery in children. Study population size considerations of future prospective clinical studies of clonidine in peripheral nerve blocks are essential and could be based on this and previously published studies .…”

mentioning

confidence: 99%

The addition of clonidine to bupivacaine in saphenous/sciatic nerve blocks in children

Trifa

Engelhardt

Khalifa

2016

Pediatric Anesthesia

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Clonidine does not improve quality of ropivacaine axillary brachial plexus block in children

Abstract: Ropivacaine (0.2% 0.4 ml · kg(-1) ) for ABPB provides sufficient postoperative analgesia in children scheduled for forearm or hand surgery. The addition of clonidine to ABPB does not improve overall postoperative analgesia but may increase the time to first analgesia request.

Cited by 27 publications

References 29 publications

Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

Feasibility, efficacy, and safety of ultrasound‐guided axillary plexus blockade in pediatric patients with epidermolysis bullosa dystrophica

Brachial plexus block: Comparison of two different doses of clonidine added to bupivacaine

The addition of clonidine to bupivacaine in saphenous/sciatic nerve blocks in children

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