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作为腋路阻滞给药时,可乐定若作为唯一的镇痛药使用,不会影响术后疼痛。

Clonidine administered as an axillary block does not affect postoperative pain when given as the sole analgesic.

作者信息

Sia S, Lepri A

机构信息

Department of Anesthesiology, Centro Traumatologico Ortopedico, Firenze, Italy.

出版信息

Anesth Analg. 1999 May;88(5):1109-12. doi: 10.1097/00000539-199905000-00027.

Abstract

UNLABELLED

Used as the sole analgesic, clonidine produces analgesia after epidural, intrathecal, and intraarticular administration. We conducted this double-blinded study to determine whether clonidine has analgesic effects when administered into the brachial plexus sheath. At the conclusion of hand or forearm surgery, performed under axillary brachial plexus block, 45 patients were randomly divided into three groups of 15 each to receive, through an axillary catheter, 15 mL of saline (Group Saline), clonidine 150 microg in 15 mL of saline (Group Clonidine), or bupivacaine 15 mL (Group Bupivacaine). The analgesic effects of the three solutions were evaluated for 6 h. Times to onset of pain and to first analgesic request were longer, and the total dose of pain medication was smaller in Group Bupivacaine compared with the other groups. Visual analog scores were significantly lower in Group Bupivacaine. There was no significant difference in time to onset of pain, time to first analgesic request, total dose of pain medication, and visual analog scores between Group Saline and Group Clonidine at any time. We conclude that the administration of clonidine 150 microg into the brachial plexus sheath does not prolong the onset of postoperative pain.

IMPLICATIONS

Used as the sole analgesic, clonidine produces analgesia after epidural, intrathecal, and intraarticular administration. It also prolongs the analgesic effect of brachial plexus block when mixed with local anesthetics. In this study, the administration of clonidine 150 microg alone into the brachial plexus sheath did not produce postoperative analgesia.

摘要

未标记

可乐定作为单一镇痛药使用时,经硬膜外、鞘内和关节内给药后可产生镇痛作用。我们进行了这项双盲研究,以确定可乐定注入臂丛神经鞘时是否具有镇痛效果。在腋路臂丛神经阻滞下进行手部或前臂手术后,45例患者被随机分为三组,每组15例,通过腋静脉导管分别接受15ml生理盐水(生理盐水组)、15ml生理盐水中含150μg可乐定(可乐定组)或15ml布比卡因(布比卡因组)。评估三种溶液的镇痛效果6小时。与其他组相比,布比卡因组疼痛开始时间和首次镇痛需求时间更长,且镇痛药物总剂量更小。布比卡因组的视觉模拟评分显著更低。在任何时间,生理盐水组和可乐定组之间在疼痛开始时间、首次镇痛需求时间、镇痛药物总剂量和视觉模拟评分方面均无显著差异。我们得出结论,向臂丛神经鞘内注入150μg可乐定不会延长术后疼痛的开始时间。

启示

可乐定作为单一镇痛药使用时,经硬膜外鞘内和关节内给药后可产生镇痛作用。当与局部麻醉药混合时,它还可延长臂丛神经阻滞的镇痛效果。在本研究中,单独向臂丛神经鞘内注入150μg可乐定未产生术后镇痛作用。

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