Bonnet F, Boico O, Rostaing S, Loriferne J F, Saada M
Department d'Anesthesie et Reanimation 2, Hopital Henri Mondor, Creteil, France.
Anesthesiology. 1990 Mar;72(3):423-7. doi: 10.1097/00000542-199003000-00004.
To compare the analgesic efficacy and plasma concentration of intramuscular (IM) versus epidural (EP) clonidine, 20 patients recovering from orthopedic or perineal surgery were randomly divided into two groups of ten. Clonidine (2 micrograms/kg) was administered epidurally in group 1 and intramuscularly in group 2. Analgesia was assessed using a visual analog scale (VAS) over a period of 6 h following clonidine administration. Venous blood samples were obtained at specific intervals for radioimmunoassay determination of plasma clonidine concentrations. The maximum reduction in VAS pain score was 78.5 +/- 20.6% in the EP group and 68.1 +/- 31.5% in the IM group (NS). Onset of analgesia was similar (within 15 min of injection), but duration tended to be longer after epidural than intramuscular administration (208 +/- 87 min vs. 168 +/- 95 min, mean +/- SD, P greater than 0.05). The peak plasma clonidine concentration after EP injection was 0.82 +/- 0.22 ng/ml and 1.02 +/- 0.76 ng/ml after IM injection. Hypotension, bradycardia, and drowsiness occurred with both methods of administration. None of these effects required treatment. Thus, in postoperative patients clonidine produces similar analgesia and side effects after parenteral or EP administration.
为比较肌内注射（IM）与硬膜外注射（EP）可乐定的镇痛效果及血浆浓度，将20例骨科或会阴部手术后恢复的患者随机分为两组，每组10例。第1组硬膜外注射可乐定（2微克/千克），第2组肌内注射。在可乐定给药后的6小时内，使用视觉模拟评分法（VAS）评估镇痛效果。在特定时间间隔采集静脉血样，用放射免疫分析法测定血浆可乐定浓度。硬膜外组VAS疼痛评分的最大降低幅度为78.5±20.6%，肌内注射组为68.1±31.5%（无显著性差异）。镇痛起效时间相似（注射后15分钟内），但硬膜外给药后的持续时间比肌内注射长（分别为208±87分钟和168±95分钟，均值±标准差，P＞0.05）。硬膜外注射后可乐定血浆峰值浓度为0.82±0.22纳克/毫升，肌内注射后为1.02±0.76纳克/毫升。两种给药方法均出现低血压、心动过缓和嗜睡。这些影响均无需治疗。因此，在术后患者中，可乐定经胃肠外或硬膜外给药后产生相似的镇痛效果和副作用。
