Clonidine combined with small-dose bupivacaine during spinal anesthesia for inguinal herniorrhaphy: a randomized double-blinded study.
The aim of this randomized double-blinded study was to see whether the addition of small-dose clonidine to small-dose bupivacaine for spinal anesthesia prolonged the duration of postoperative analgesia and also provided a sufficient block duration that would be adequate for inguinal herniorrhaphy. We randomized 45 patients to 3 groups receiving intrathecal hyperbaric bupivacaine 6 mg combined with saline (Group B), clonidine 15 micro g (Group BC15), or clonidine 30 micro g (Group BC30); all solutions were diluted with saline to 3 mL. The sensory block level was insufficient for surgery in five patients in Group B, and these patients were given general anesthesia. Patients in Groups BC15 and BC30 had a significantly higher spread of analgesia (two to four dermatomes) than those in Group B. Two-segment regression, return of S1 sensation, and regression of motor block were significantly longer in Group BC30 than in Group B. The addition of clonidine 15 and 30 micro g to bupivacaine prolonged time to first analgesic request and decreased postoperative pain with minimal risk of hypotension. We conclude that clonidine 15 micro g with bupivacaine 6 mg produced an effective spinal anesthesia and recommend this dose for inguinal herniorrhaphy, because it did not prolong the motor block.


CONCLUSIONS
The addition of clonidine 15 micro g to 6 mg of hyperbaric bupivacaine increases the spread of analgesia, prolongs the time to first analgesic request, and decreases postoperative pain, compared with bupivacaine alone, during inguinal herniorrhaphy under spinal anesthesia.
Dobrydnjov
I
I
Departments of *Anesthesiology and Intensive Care and †Surgery, University Hospital, Örebro, Sweden.
Axelsson
K
K
Thörn
S-E
SE
Matthiesen
P
P
Klockhoff
H
H
Holmström
B
B
Gupta
A
A
D000316:Adrenergic alpha-Agonists; D000328:Adult; D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local; D002045:Bupivacaine; D003000:Clonidine; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D017060:Patient Satisfaction; D011229:Preanesthetic Medication; D011446:Prospective Studies
D000316:Adrenergic alpha-Agonists; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D003000:Clonidine; D002045:Bupivacaine