Syal K, Dogra Rk, Ohri A, Chauhan G, Goel A
Senior Residents, Department of Anaesthesia, IGMC, Shimla (H.P.).
J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):87-90.
To compare the effects of addition of Clonidine (60 μg) to Epidural Bupivacaine (0.125%) for labour analgesia, with regard to duration of analgesia, duration of labour, ambulation, incidence of instrumentation and caesarean section, foetal outcome, patient satisfaction and side effects. PATIENTS #ENTITYSTARTX00026;
On demand, epidural labour analgesia was given to 50 nulliparous healthy term parturients (cephalic presentation), divided in two groups randomly. Group I received bupivacaine (0.125%) alone, whereas Group II received bupivacaine (0.125%) along with Clonidine (60 μg). 10 ml of 0.125% bupivacaine was injected as first dose and further doses titrated with patient relief (Numerical Rating Scale <3). Top ups were given whenever Numerical Rating Scale went above 5.
There was statistically significant prolongation of duration of analgesia in Group II, with no difference in duration of labour, ambulation, incidence of instrumentation and caesarean section or foetal outcome. Also clonidine gave dose sparing effect to bupivacaine and there was better patient satisfaction without any significant side effects in Group II.
Clonidine is a useful adjunct to bupivacaine for epidural labour analgesia and can be considered as alternative to opioids.
比较在硬膜外布比卡因（0.125%）中添加可乐定（60μg）用于分娩镇痛时，在镇痛持续时间、产程、活动能力、器械助产和剖宫产发生率、胎儿结局、患者满意度及副作用方面的效果。患者……
对50例健康初产足月产妇（头先露）按需给予硬膜外分娩镇痛，随机分为两组。第一组仅接受布比卡因（0.125%），而第二组接受布比卡因（0.125%）加可乐定（60μg）。首次剂量注射10ml 0.125%布比卡因，后续剂量根据患者疼痛缓解情况（数字评分量表<3）进行滴定。当数字评分量表高于5时给予追加剂量。
第二组镇痛持续时间有统计学意义的延长，产程、活动能力、器械助产和剖宫产发生率或胎儿结局无差异。可乐定还对布比卡因有剂量节省作用，且第二组患者满意度更高，无任何显著副作用。
可乐定是布比卡因用于硬膜外分娩镇痛的有用辅助药物，可被视为阿片类药物的替代品。
