Intrathecal low‐dose hyperbaric bupivacaine–clonidine combination in outpatient knee arthroscopy: a randomized controlled trial

Abstract

The addition of 15 microg clonidine to 5 mg of intrathecal hyperbaric bupivacaine prolongs the duration of motor block and improves the quality of the block.

Clonidine versus butorphanol as adjuvant to 0.5% hyperbaric bupivacaine to enhance the onset and duration of subarachnoid blockade with postoperative analgesia during orthopaedic surgeries-A randomized study

“…The mean time to two-segment regression, regression to L3 dermatome and time to first rescue analgesic request was significantly more in clonidine group than butorphanol group. Our findings were similar to study conducted by Van Tuijl et al [13,14] and Dobrydnjov et al [15] suggesting that the dose of intrathecal clonidine does not affect the mean maximal level of sensory block.…”

A randomised trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for spinal anaesthesia for knee arthroscopy

“…However, while there was no significant prolongation of motor block in patients given intrathecal fentanyl, there was a significant prolongation of the motor block in patients who received intrathecal clonidine 15 μg along with ropivacaine. Van Tuijl et al 15 found that the addition recorded at about six hours. One patient in Group RF had pruritus.…”

“…This prolongation of sensory block by addition of adjuvants like fentanyl and clonidine has been proven by several earlier investigators. 5,7,[14][15][16][17] The antinociceptive properties of clonidine indicate that it might be useful as an alternative to intrathecal opioids for postoperative analgesia. However, while there was no significant prolongation of motor block in patients given intrathecal fentanyl, there was a significant prolongation of the motor block in patients who received intrathecal clonidine 15 μg along with ropivacaine.…”

Intrathecal Clonidine as Spinal Anaesthesia Adjuvant — Is there a Magical Dose?

“…Hemodynamic stability was maintained and they found no differences in sedation level. van Tuijl and coworkers [37] investigated the effect of 0, 15 and 30 µg of clonidine added to 5 mg hyperbaric bupivacaine on the duration of motor block, analgesia and ability to void after knee arthroscopy. They found that clonidine increased motor block duration by 25 and 34 min respectively.…”

“…[36] Several investigations in patients undergoing knee arthroscopy have shown that low doses of clonidine [15 up to 45 µg) added to low doses of intrathecal hyperbaric bupivacaine [5-6 mg) improves the quality of anaesthesia, prolong the motor block, without affecting time to home discharge in outpatients. [37] In 60 ambulatory patients undergoing knee arthroscopy Marrivirta et al [38] added 75 µg clonidine to 6 mg spinal hyperbaric bupivacaine vs. 6 mg bupivacaine alone. These researchers found that motor block was prolonged in those patients who received clonidine without affecting home-readiness.…”