Does clonidine 50 microg improve cervical plexus block obtained with ropivacaine 150 mg for carotid endarterectomy? A randomized, double-blinded study.
OBJECTIVE
To evaluate the effects of adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block in patients undergoing elective carotid endarterectomy (TEA).


METHODS
Randomized, double-blind study.


METHODS
Departments of Anesthesia and Vascular Surgery of a university hospital.


METHODS
40 ASA physical status II and III patients undergoing elective TEA during superficial cervical plexus block.


METHODS
Superficial cervical plexus block was placed using 20 mL of 0.75% ropivacaine alone (Ropi group, n = 20) or with the addition of 50 microg clonidine (Ropi-Clonidine group, n = 20). If required, analgesic supplementation was given with local infiltration with 1% lidocaine and intravenous fentanyl (50-microg boluses). Nerve block profile, need for intraoperative analgesic supplementation, and time to first analgesic request were recorded.


RESULTS
Median (range) onset time was 10 minutes (5-25 min) in the Ropi group and 5 minutes (5-20 min) in the Ropi-Clonidine group (P < 0.05). Intraoperative consumption of both 1% lidocaine and fentanyl was higher in patients of the Ropi group (15 mL [0-25 mL] and 250 microg [50-300 microg]) than in patients of the Ropi-Clonidine group (8 mL [0-20 mL] and 0 microg [0-150 microg]; P < 0.05 and P < 0.05, respectively). First postoperative analgesic request occurred after 17 hours (10-24 hrs) in the Ropi group and 20 hours (10-24 hrs) in the Ropi-Clonidine group (P > 0.05).


CONCLUSIONS
Adding 50 microg clonidine to 150 mg ropivacaine for superficial cervical plexus block shortened the onset time and improved the quality of surgical anesthesia in patients undergoing elective TEA.
Danelli
Giorgio
G
Department of Anesthesiology, University of Parma, 43100 Parma, Italy. gdanelli@ao.pr.it
Nuzzi
M
M
Salcuni
P F
PF
Caberti
L
L
Berti
M
M
Rossini
E
E
Casati
A
A
Fanelli
G
G
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002572:Cervical Plexus / Q000187:drug effects*; D003000:Clonidine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000188:drug therapy; D010149:Postoperative Pain / Q000188:drug therapy; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome
D000577:Amides; D000700:Analgesics; D000779:Anesthetics, Local; D000077212:Ropivacaine; D003000:Clonidine