Singh Shivinder, Aggarwal Amitabh
Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, India.
Indian J Anaesth. 2010 Nov;54(6):552-7. doi: 10.4103/0019-5049.72646.
We compared the effects of clonidine added to bupivacaine with bupivacaine alone on supraclavicular brachial plexus block and observed the side-effects of both the groups. In this prospective, randomized, double-blinded, controlled trial, two groups of 25 patients each were investigated using (i) 40 ml of bupivacaine 0.25% plus 0.150 mg of clonidine and (ii) 40 ml of bupivacaine 0.25% plus 1 ml of NaCl 0.9, respectively. The onset of motor and sensory block and duration of sensory block were recorded along with monitoring of heart rate, non-invasive blood pressure, oxygen saturation and sedation. It was observed that addition of clonidine to bupivacaine resulted in faster onset of sensory block, longer duration of analgesia (as assessed by visual analogue score), prolongation of the motor block (as assessed by modified Lovett Rating Scale), prolongation of the duration of recovery of sensation and no association with any haemodynamic changes (heart rate and blood pressure), sedation or any other adverse effects. These findings suggest that clonidine added to bupivacaine is an attractive option for improving the quality and duration of supraclavicular brachial plexus block in upper limb surgeries.
我们比较了可乐定添加到布比卡因中与单独使用布比卡因对锁骨上臂丛神经阻滞的影响,并观察了两组的副作用。在这项前瞻性、随机、双盲、对照试验中,每组25例患者,分别使用(i)40 ml 0.25%布比卡因加0.150 mg可乐定和(ii)40 ml 0.25%布比卡因加1 ml 0.9%氯化钠进行研究。记录运动和感觉阻滞的起效时间以及感觉阻滞的持续时间,同时监测心率、无创血压、血氧饱和度和镇静情况。结果发现,布比卡因中添加可乐定可使感觉阻滞起效更快、镇痛持续时间更长(通过视觉模拟评分评估)、运动阻滞时间延长(通过改良Lovett评分量表评估)、感觉恢复持续时间延长,且与任何血流动力学变化(心率和血压)、镇静或任何其他不良反应无关。这些发现表明,布比卡因中添加可乐定是改善上肢手术中锁骨上臂丛神经阻滞质量和持续时间的一个有吸引力的选择。