Goyagi T, Nishikawa T
Department of Anesthesiology, University of Tsukuba, Ibaraki, Japan.
Anesth Analg. 1996 Jun;82(6):1192-6. doi: 10.1097/00000539-199606000-00016.
Since clonidine potentiates the analgesia by morphine, the current study was performed to investigate whether oral clonidine premedication would enhance the postoperative analgesia by intrathecal morphine. Twenty-six patients, aged 37-60 yr, schedule for abdominal total hysterectomy under spinal anesthesia, were studied. Patients were randomly allocated to one of two groups; the clonidine group (n = 13) received oral clonidine approximately 5 micrograms/kg, and the control group (n = 13) received no clonidine. All patients received hyperbaric tetracaine 12 mg dissolved in 10% dextrose and morphine 0.2 mg for spinal anesthesia. We measured duration of analgesia (time to the first request for supplemental analgesics) and motor block. We also recorded the total number of injections of supplemental analgesics, and intensity of postoperative visual analog pain scores, nausea, and pruritus for 48 h after intrathecal administration. Duration of analgesia in the clonidine group was longer than the control group (2017 +/- 263 vs 1190 +/- 199 min, mean +/- SEM; P < 0.05). Although there was no difference in the total number of injections of supplemental analgesics (1.1 +/- 0.4 and 2.2 +/- 0.3 in the clonidine and control groups, respectively), the number of patients not requiring supplemental analgesics during the entire study period was larger in the clonidine group than the control group (six patients versus one patient; P < 0.05). There were no differences at any observation point between groups in visual analog pain scores, or the incidence of nausea and pruritus. Oral clonidine preanesthetic medication enhances the postoperative analgesia of intrathecal morphine plus tetracaine without increasing the intensity of side effects from morphine.
由于可乐定可增强吗啡的镇痛作用，因此进行了本研究以探讨术前口服可乐定是否会增强鞘内注射吗啡的术后镇痛效果。研究对象为26例年龄在37至60岁之间、计划在脊髓麻醉下进行腹式全子宫切除术的患者。患者被随机分为两组；可乐定组（n = 13）口服约5微克/千克的可乐定，对照组（n = 13）未服用可乐定。所有患者均接受溶解于10%葡萄糖中的12毫克高压布比卡因和0.2毫克吗啡进行脊髓麻醉。我们测量了镇痛持续时间（首次要求追加镇痛药的时间）和运动阻滞情况。我们还记录了追加镇痛药的注射总次数，以及鞘内给药后48小时内术后视觉模拟疼痛评分、恶心和瘙痒的强度。可乐定组的镇痛持续时间长于对照组（分别为2017 +/- 263分钟和1190 +/- 199分钟，平均值 +/- 标准误；P < 0.05）。虽然追加镇痛药的注射总次数在两组间无差异（可乐定组和对照组分别为1.1 +/- 0.4次和2.2 +/- 0.3次），但在整个研究期间不需要追加镇痛药的患者数量在可乐定组多于对照组（6例患者对1例患者；P < 0.05）。两组在任何观察点的视觉模拟疼痛评分、恶心和瘙痒发生率均无差异。术前口服可乐定可增强鞘内注射吗啡加布比卡因的术后镇痛效果，且不会增加吗啡副作用的强度。
