Epidural Clonidine Analgesia following Surgery

Eisenach, James C.; Lysak, Steven Z.; Viscomi, Christopher M.

doi:10.1097/00000542-198911000-00003

Cited by 188 publications

(73 citation statements)

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“…Clinically, clonidine has been used extensively for the treatment of severe, acute (Tamsen & Gordh, 1984;Eisenach et al, 1989a;Mendez et al, 1990) and chronic (Coombs et al, 1986;Max et al, 1988;Eisenach et al, 1989b) pain conditions following either epidural or spinal administration. Clonidine (Bloor & Flacke, 1982) and Dex (Segal et al, 1988) have also been found to be useful adjuncts to general anaesthetics by reducing the anaesthetic requirement during surgery.…”

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confidence: 99%

“…Clonidine (Bloor & Flacke, 1982) and Dex (Segal et al, 1988) have also been found to be useful adjuncts to general anaesthetics by reducing the anaesthetic requirement during surgery. However, while e ective analgesia is obtained by these restricted routes of administration, widespread use for the treatment of pain following systemic administration is precluded by a series of adverse side-e ects including sedation, profound systemic hypotension and bradycardia (Bonnet et al, 1989;Eisenach et al, 1989a;Maze & Tranquilli, 1991).…”

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Assessment of the role of α₂‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Hunter¹,

Fontana²,

Hedley³

et al. 1997

British J Pharmacology

248

139

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1 The role of a 2 -adrenoceptor (AR) subtypes in the modulation of acute nociception, motor behaviour and body temperature, has been investigated by determining the activity of the a 2 AR selective agonist dexmedetomidine (Dex) in mice devoid of individual a 2 AR subtypes through either a point (a 2A ) or null (a 2B /a 2C ) mutation (`knock-out').2 In a rodent model of acute thermal nociception, the mouse tail immersion test, Dex, in wild type (WT) control animals, produced a dose-dependent increase in the threshold for tail withdrawal from a 528C water bath with mean ED 50 values of 99.9+14.5 (a 2A ), 94.6+17.8 (a 2B ) and 116.0+17.1 (a 2C ) mg kg 71 , i.p. 3 In comparison to the WT controls, Dex (100 ± 1000 mg kg 71 , i.p.), was completely ine ective as an antinociceptive agent in the tail immersion test in the a 2A AR D79N mutant animals. Conversely, in the a 2B AR and a 2C AR knock-outs, Dex produced a dose-dependent antinociceptive e ect that was not signi®cantly di erent from that observed in WT controls, with ED 50 values of 85.9+15.0 (P40.05 vs WT control) and 226.0+62.7 (P40.05 vs WT control) mg kg 71 i.p., respectively. 4 Dex (10 ± 300 mg kg 71 , i.p.) produced a dose-dependent reduction in spontaneous locomotor activity in the a 2A , a 2B and a 2C AR WT control animals with ED 50 values of 30.1+9.0, 23.5+7.1 and 32.3+4.6 mg kg 71 , i.p., respectively. Again, Dex (100 ± 1000 mg kg 71 , i.p.) was ine ective at modulating motor behaviour in the a 2A AR D79N mutants. In the a 2B AR and a 2C AR knock-out mice, Dex produced a dose-dependent reduction in spontaneous locomotor activity with ED 50 values of 29.1+6.4 (P40.05 vs WT control) and 57.5+11.3 (P40.05 vs WT control) mg kg 71 , respectively. 5 Dex was also found to produce a dose-dependent reduction in body temperature in the a 2A , a 2B and a 2C AR WT control mice with ED 50 values of 60.6+11.0, 16.2+2.5 and 47.2+9.1 mg kg 71 , i.p., respectively. In the a 2A AR D79N mutants, Dex had no e ect on body temperature at a dose (100 mg kg 71 , i.p.) that produced a signi®cant reduction (76.2+0.58C; P50.01 vs vehicle) in temperature in WT controls. However, higher doses of Dex (300 and 1000 mg kg 71 , i.p) produced a small, but statistically signi®cant decrease in temperature corresponding to 71.7+0.48C and 72.4+0.38C (both P50.01 vs vehicle), respectively. In the a 2B AR and a 2C AR knock-out mice, Dex produced a dose-dependent reduction in body temperature with ED 50 values of 28.4+4.8 (P40.05 vs WT control) and 54.1+8.0 (P40.05 vs WT control) mg kg 71 , respectively. 6 In conclusion, the data are consistent with the a 2A AR being the predominant subtype involved in the mediation of the antinociceptive, sedative and hypothermic actions of Dex. This pro®le would appear to indicate that an a 2A AR subtype selective analgesic will have a narrow therapeutic window, particularly following systemic administration.

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confidence: 99%

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confidence: 99%

Assessment of the role of α₂‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Hunter¹,

Fontana²,

Hedley³

et al. 1997

British J Pharmacology

248

139

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“…Muhtemelen alfa 2 adrenerjik reseptörlerin supraspinal stimülasyonu ile ortaya çıkan sedatif etki hiçbir dönemde ağrı ölçümlerini engelleyecek kadar ağır olmadı ( 8,9,11,12 ).…”

Section: Discussionunclassified

Postoperatif Ağri Tedavi̇si̇nde Epi̇dural Kloni̇di̇n İle Fentani̇li̇n Karşilaştirilmasi

Ömer;LEBLEBİCİ¹

1996

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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“…Hypotension results primarily from a reduction in systemic vascular resistance, with little change in cardiac output. Clonidine reduces heart rate by direct and central mechanisms [13] , and in some human studies, epidural administration has significantly reduced heart rate. [11,13] We observed that nausea, vomiting hypotension were not significant in both groups.…”

Section: Rescue Analgesiamentioning

confidence: 99%

“…Clonidine reduces heart rate by direct and central mechanisms [13] , and in some human studies, epidural administration has significantly reduced heart rate. [11,13] We observed that nausea, vomiting hypotension were not significant in both groups. The groups did not differ statistically concerning PONV and antiemetic drug consumption.…”

Section: Rescue Analgesiamentioning

confidence: 99%

A Comparative Study of Qualitative Analgesia for Postoperative Period between Ropivacaine and Ropivacaine with Clonidine in Epidural Block

Saini¹,

Khandelwal²,

Sharma³

et al. 2017

IOSR JDMS

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Epidural Clonidine Analgesia following Surgery

Cited by 188 publications

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Assessment of the role of α₂‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Assessment of the role of α₂‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Postoperatif Ağri Tedavi̇si̇nde Epi̇dural Kloni̇di̇n İle Fentani̇li̇n Karşilaştirilmasi

A Comparative Study of Qualitative Analgesia for Postoperative Period between Ropivacaine and Ropivacaine with Clonidine in Epidural Block

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Epidural Clonidine Analgesia following Surgery

Cited by 188 publications

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Assessment of the role of α2‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Assessment of the role of α2‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Postoperatif Ağri Tedavi̇si̇nde Epi̇dural Kloni̇di̇n İle Fentani̇li̇n Karşilaştirilmasi

A Comparative Study of Qualitative Analgesia for Postoperative Period between Ropivacaine and Ropivacaine with Clonidine in Epidural Block

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Assessment of the role of α₂‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice

Assessment of the role of α₂‐adrenoceptor subtypes in the antinociceptive, sedative and hypothermic action of dexmedetomidine in transgenic mice