Danelli G, Nuzzi M, Salcuni PF, Caberti L, Berti M, Rossini E, Casati A, Fanelli G. Does clonidine 50 μg improve cervical plexus block obtained with ropivacaine 150 mg for carotid endarterectomy? A randomized, double-blinded study.
J Clin Anesth 2006;
18:585-8. [PMID:
17175427 DOI:
10.1016/j.jclinane.2006.03.016]
[Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 03/10/2006] [Accepted: 03/17/2006] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE
To evaluate the effects of adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block in patients undergoing elective carotid endarterectomy (TEA).
DESIGN
Randomized, double-blind study.
SETTING
Departments of Anesthesia and Vascular Surgery of a university hospital.
PATIENTS
40 ASA physical status II and III patients undergoing elective TEA during superficial cervical plexus block.
INTERVENTIONS
Superficial cervical plexus block was placed using 20 mL of 0.75% ropivacaine alone (Ropi group, n = 20) or with the addition of 50 microg clonidine (Ropi-Clonidine group, n = 20). If required, analgesic supplementation was given with local infiltration with 1% lidocaine and intravenous fentanyl (50-microg boluses). Nerve block profile, need for intraoperative analgesic supplementation, and time to first analgesic request were recorded.
MEASUREMENTS AND MAIN RESULTS
Median (range) onset time was 10 minutes (5-25 min) in the Ropi group and 5 minutes (5-20 min) in the Ropi-Clonidine group (P < 0.05). Intraoperative consumption of both 1% lidocaine and fentanyl was higher in patients of the Ropi group (15 mL [0-25 mL] and 250 microg [50-300 microg]) than in patients of the Ropi-Clonidine group (8 mL [0-20 mL] and 0 microg [0-150 microg]; P < 0.05 and P < 0.05, respectively). First postoperative analgesic request occurred after 17 hours (10-24 hrs) in the Ropi group and 20 hours (10-24 hrs) in the Ropi-Clonidine group (P > 0.05).
CONCLUSIONS
Adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block shortened the onset time and improved the quality of surgical anesthesia in patients undergoing elective TEA.
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