title: Fentanyl and clonidine as adjunctive analgesics with levobupivacaine in paravertebral analgesia for breast surgery.
abstract: The addition of fentanyl or clonidine to levobupivacaine was evaluated in patients undergoing breast surgery under general anaesthesia with intra- and postoperative paravertebral analgesia. Patients were randomly allocated to four groups: Group L received 19 ml bolus levobupivacaine 0.25% plus 1 ml saline followed by an infusion of levobupivacaine 0.1%; Group LF received 19 ml bolus levobupivacaine 0.25% plus fentanyl 50 microg followed by an infusion of levobupivacaine 0.05% with fentanyl 4 microg x ml(-1); Group LC received 19 ml bolus levobupivacaine 0.25% plus clonidine 150 microg followed by an infusion of levobupivacaine 0.05% with clonidine 3 microg x ml(-1); Group C (control) received general anaesthesia without paravertebral analgesia. All groups received postoperative i.v. morphine patient controlled analgesia (PCA). Although mean (SD) postoperative PCA morphine consumption was decreased in LF [7.9 (4.1) mg] and LC [5.9 (3.5) mg]vs L [27.7 (8.6) mg] or C patients [21.7 (5.5) mg], p < 0.01, paravertebral fentanyl and clonidine were associated with significantly increased vomiting and hypotension, respectively.
authors.affiliation: Department of Anaesthesia, Intensive Care and Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland. crina@ireland.com
authors.forename: C L
authors.initials: CL
authors.lastname: Burlacu
authors.forename: H P
authors.initials: HP
authors.lastname: Frizelle
authors.forename: D C
authors.initials: DC
authors.lastname: Moriarty
authors.forename: D J
authors.initials: DJ
authors.lastname: Buggy
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000700:Analgesics; D000701:Analgesics, Opioid; D001943:Breast Neoplasms / Q000601:surgery; D002045:Bupivacaine / Q000031:analogs & derivatives; D003000:Clonidine; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl; D006801:Humans; D000077554:Levobupivacaine; D008408:Mastectomy; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D004338:Drug Combinations; D009020:Morphine; D000077554:Levobupivacaine; D003000:Clonidine; D005283:Fentanyl; D002045:Bupivacaine