Document Detail


Small dose of clonidine mixed with low-dose ropivacaine and fentanyl for epidural analgesia after total knee arthroplasty.
MedLine Citation:
PMID:  15377579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We studied whether a small dose of clonidine added to a ropivacaine-fentanyl mixture improves epidural analgesia without provoking side effects typically related to larger amounts of epidural clonidine. METHODS: In this randomized, double-blinded study, patients (< or =85 yr, ASA I-III) underwent total knee arthroplasty (TKA) performed under spinal anaesthesia. After the operation, patients received an epidural infusion consisting of ropivacaine 2 mg ml(-1) and fentanyl 5 microg ml(-1) either without (Group RF, n=33) or with clonidine 2 microg ml(-1) (Group RFC, n=36). The infusion rate was adjusted within the range 3-7 ml h(-1). RESULTS: Average rate of infusion was slightly smaller in Group RFC than in Group RF (mean (sd) 4.7 (0.72) vs 5.2 (0.8) ml h(-1), P=0.004). Compared with the RF group, patients in the RFC group required significantly less rescue pain medication, that is i.m. oxycodone (median (25th, 75th percentile) 0 (0, 7) vs 7 (0, 12) mg, P=0.027). Arterial pressure and heart rate were slightly lower in Group RFC throughout the study period (mean difference between the groups 5 mm Hg (P<0.002) and 3 min(-1) (P=0.12), respectively). The groups did not differ statistically with respect to nausea, motor block, and sedation. CONCLUSIONS: The small amount of clonidine added to the low-dose ropivacaine-fentanyl mixture reduced the need for opioid rescue pain medication after TKA. Clonidine slightly decreased arterial pressure and heart rate without jeopardizing haemodynamics. Otherwise, the side effect profiles were comparable in both groups.
Authors:
J G Förster; P H Rosenberg
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2004-09-17
Journal Detail:
Title:  British journal of anaesthesia     Volume:  93     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-08     Completed Date:  2004-12-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  670-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, PB 340, FIN-00029 Helsinki, Finland. johannes.forster@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Amides / administration & dosage
Analgesia, Epidural / methods*
Analgesics / administration & dosage*
Analgesics, Opioid / administration & dosage
Anesthetics, Local / administration & dosage
Arthroplasty, Replacement, Knee*
Clonidine / administration & dosage*
Double-Blind Method
Drug Administration Schedule
Drug Combinations
Female
Fentanyl / administration & dosage
Hemodynamics / drug effects
Humans
Male
Middle Aged
Oxygen / blood
Pain Measurement
Pain, Postoperative / prevention & control*
Patient Satisfaction
Chemical
Reg. No./Substance:
0/Amides; 0/Analgesics; 0/Analgesics, Opioid; 0/Anesthetics, Local; 0/Drug Combinations; 4205-90-7/Clonidine; 437-38-7/Fentanyl; 7782-44-7/Oxygen; 84057-95-4/ropivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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