Singelyn F J, Dangoisse M, Bartholomée S, Gouverneur J M
Department of Anesthesiology, St. Luc Hospital, UCL School of Medicine, Brussels.
Reg Anesth. 1992 May-Jun;17(3):148-50.
This study evaluates the effects of clonidine added to mepivacaine on the duration of anesthesia and analgesia after axillary brachial plexus block.
Thirty patients scheduled for elective hand surgery were divided into three equal groups in a randomized, double-blinded fashion. An axillary perivascular brachial plexus block was performed with 40 ml 1% mepivacaine plus 1:200,000 epinephrine in the three groups. Group B also received 150 micrograms clonidine subcutaneously and Group C had the same dose of clonidine mixed with the local anesthetic and injected into the plexus sheath. The following variables were recorded: onset time, duration of anesthesia, duration of analgesia, postoperative pain score, intake of analgesics, and adverse effects.
The three groups were comparable in terms of age, sex, weight, height, onset time of anesthesia, postoperative pain score, and analgesic requirement. The duration of anesthesia and analgesia was comparable in Groups A and B, but both variables were significantly increased in Group C: the duration of anesthesia and analgesia were prolonged, respectively, by 37 +/- 6% and 103 +/- 16% when compared to Group A and by 32 +/- 7% and 89 +/- 15% when compared to Group B. No side effects were reported.
One hundred fifty micrograms clonidine added to mepivacaine for brachial plexus block prolongs the duration of anesthesia and analgesia. Our results suggest that this effect of clonidine is local rather than systemic.
本研究评估可乐定添加到甲哌卡因中对腋路臂丛神经阻滞后麻醉和镇痛持续时间的影响。
30例择期手部手术患者以随机、双盲方式分为三组。三组均采用40ml 1%甲哌卡因加1:200,000肾上腺素行腋路血管周围臂丛神经阻滞。B组还皮下注射150μg可乐定，C组将相同剂量的可乐定与局麻药混合注入神经丛鞘。记录以下变量：起效时间、麻醉持续时间、镇痛持续时间、术后疼痛评分、镇痛药摄入量及不良反应。
三组在年龄、性别、体重、身高、麻醉起效时间、术后疼痛评分及镇痛需求方面具有可比性。A组和B组的麻醉和镇痛持续时间相当，但C组这两个变量均显著增加：与A组相比，麻醉和镇痛持续时间分别延长37±6%和103±16%；与B组相比，分别延长32±7%和89±15%。未报告副作用。
臂丛神经阻滞时，甲哌卡因中添加150μg可乐定可延长麻醉和镇痛持续时间。我们的结果表明，可乐定的这种作用是局部性而非全身性的。
