Impact of the addition of sufentanil 5 μg or clonidine 75 μg on the minimum local analgesic concentration of ropivacaine for epidural analgesia in labour: a randomized comparison

Dewandre, Pierre-Yves; Kirsch, Muriëlle; Bonhomme, Vincent; Columb, Malachy O.; Hans, Pol; Brichant, Jean-François

doi:10.1016/j.ijoa.2008.05.005

Cited by 17 publications

(10 citation statements)

References 47 publications

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“…This confirms the equianalgesic properties of sufentanil 5 lg and clonidine 75 lg demonstrated with the MLAC model in a previous study. 21 This study reports a 42% incidence of hypotension requiring ephedrine administration in group RC that is significantly higher than the 8% in group RS. Several studies have reported that epidural administration of clonidine was associated with an increased incidence or trend towards maternal hypotension.…”

Section: Discussionmentioning

confidence: 57%

“…A recent study demonstrated that sufentanil 5 lg and clonidine 75 lg produce a similar reduction of the minimum local anaesthetic concentration (MLAC) of ropivacaine. 21 This finding makes comparison of side effects of equipotent doses of sufentanil and clonidine combined with clinically useful local anaesthetic concentrations feasible. The aim of the present study was to compare the side effects of two equianalgesic solutions that combined 0.2% ropivacaine with either sufentanil 5 lg or clonidine 75 lg.…”

Section: Introductionmentioning

confidence: 99%

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Side effects of the addition of clonidine 75 μg or sufentanil 5 μg to 0.2% ropivacaine for labour epidural analgesia

Dewandre

Decurninge

Bonhomme

et al. 2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Side effects of the addition of clonidine 75 μg or sufentanil 5 μg to 0.2% ropivacaine for labour epidural analgesia

Dewandre

Decurninge

Bonhomme

et al. 2010

International Journal of Obstetric Anesthesia

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“…Moreover, several studies demonstrated local anesthetic' sparing effect when lipophilic opioids or alpha2-agonists were added to local anesthetic solutions, thus improving their efficacy and reducing their side effects [36].…”

Section: Local Anestheticsmentioning

confidence: 99%

“…Opioids are often combined with epidural local anesthetics to improve the quality of analgesia and decrease local anesthetic requirements and motor blockade [36]. Analgesics are administered via epidural route to obtain selective spinal analgesia and limit systemic side effects [38].…”

Section: Opioidsmentioning

confidence: 99%

New Drugs for Epidural Analgesia

Congedo

Sgreccia

Cosmo

2009

CDT

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In recent years there has been a wide use of the epidural technique not only during surgery to provide anesthesia and analgesia, but also for obstetric and trauma as well as acute, chronic and cancer pain states. Nowadays there is an increase in the number of the epidural drugs. Local anesthetics and opioids are still the pharmacological agents more widely used epidurally, nevertheless other drugs from different pharmacological classes are administered as adjuvant to local anesthetics and opioids or are in various early stages of investigation. Regarding to local anesthetics, the most recent literature focuses on the new enantiomers, ropivacaine and levobupivacaine, the efficacy of which is similar to that of bupivacaine with a reduced risk of cardiotoxicity. About opioids, the other class of drugs mainly used, the debate, in the last years, concerned the physicochemical properties of morphine and of the more recent lipophilic agents, fentanyl and sufentanil, in order to explain the main differences in efficacy and safety. Other categories of agents have been investigated for epidural administration, such as alpha(2)-adrenergic agonists clonidine and dexmedetomidine. They are being used increasingly as adjuvants to local anesthetics and opioids. Ketamine and neostigmine, the more recent studied drugs for epidural use, are still under investigation and are not part of routine clinical practice.

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“…Addition of clonidine as an adjuvant helps in dose sparing of local anesthetic,[15] which consequently reduces the incidence of side effects associated with larger doses of these anesthetics. There have been numerous studies validating the dose sparing effect of adjuvant when used with local anesthetics; our study is an endeavor toward the same.…”

Section: Introductionmentioning

confidence: 99%

Comparison between epidural ropivacaine versus ropivacaine with clonidine in patients undergoing abdominal hysterectomy: A randomized study

2017

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Context:Regional anesthesia has emerged as one of the preferred and convenient modes for intra- and post-operative management owing to its advantage of not interfering with the metabolic functions, better tolerability, and decrease in reflex activity. In recent years, ropivacaine has increasingly replaced bupivacaine as a preferred local anesthetic because of its similar analgesic properties, lesser motor blockade, and decreased propensity of cardiotoxicity. Neuraxial adjuvant such as clonidine used in epidural anesthesia offers advantage by augmenting the local anesthetic effect and reducing the anesthetic and analgesic requirement.Aims and Objectives:Comparison of onset, duration of sensory and motor block, and any adverse effects between 0.5% ropivacaine with normal saline versus 0.5% ropivacaine with clonidine (75 μg/kg).Materials and Methods:This prospective randomized study was carried out in 50 patients (25 in each group) of American Society of Anesthesiologist Grade 1 and 2 scheduled for abdominal hysterectomy under epidural block. Group-1 (ropivacaine-clonidine [RC]): Epidural ropivacaine 20 ml (0.5%) with 0.75 μg/kg clonidine. Group-2 (ropivacaine [R]): Epidural ropivacaine 20 ml (0.5%) with normal saline. Onset, duration of sensory-motor block, heart rate, blood pressure, oxygen saturation, and respiratory rate were recorded.Statistical Analysis:The statistical analysis was done using Statistical Package for Social Sciences version 15.0. Chi-square test, ANOVA, Student's t-test, and paired t-test were used.Results:Groups were comparable with regard to demographic data and hemodynamic stability. Onset of sensory and motor blockade was faster in RC group as compared to R group. Duration of postoperative analgesia was significantly prolonged in RC group. No potential side effect was seen in either group.Conclusion:On account of faster onset, hemodynamic stability, and prolonged postoperative analgesia, ropivacaine with clonidine is a better option than ropivacaine alone.

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Impact of the addition of sufentanil 5 μg or clonidine 75 μg on the minimum local analgesic concentration of ropivacaine for epidural analgesia in labour: a randomized comparison

Cited by 17 publications

References 47 publications

Side effects of the addition of clonidine 75 μg or sufentanil 5 μg to 0.2% ropivacaine for labour epidural analgesia

Side effects of the addition of clonidine 75 μg or sufentanil 5 μg to 0.2% ropivacaine for labour epidural analgesia

New Drugs for Epidural Analgesia

Comparison between epidural ropivacaine versus ropivacaine with clonidine in patients undergoing abdominal hysterectomy: A randomized study

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