Clonidine and analgesic duration after popliteal fossa nerve blockade: randomized, double-blind, placebo-controlled study.
BACKGROUND
We tested the hypothesis that 100 microg clonidine added to 0.375% bupivacaine would prolong the duration of analgesia from popliteal fossa nerve blockade.


METHODS
Ninety-nine patients scheduled for hospital admission after foot or ankle surgery entered this randomized, double-blind, placebo-controlled trial. Patients received a popliteal fossa block (nerve stimulator technique, via the posterior approach) using 30 mL 0.375% bupivacaine, with epinephrine. Patients were randomized to receive no clonidine, 100 microg clonidine IM, or 100 microg clonidine with bupivacaine for the popliteal block. Patients also received a combined spinal-epidural anesthetic, a saphenous nerve block, and postoperative IV patient-controlled analgesia. The primary outcome was patient-reported duration of analgesia.


RESULTS
Duration of analgesia was statistically longer in the block clonidine group (18 +/- 6 h for clonidine with bupivacaine vs 14 +/- 7 h for IM clonidine and 15 +/- 7 h for control, P = 0.016 for control vs clonidine with bupivacaine). Pain scores, analgesic use, and side effects attributable to pain management were similar among groups.


CONCLUSIONS
Clonidine significantly prolongs the analgesic duration after popliteal fossa nerve blockade with bupivacaine.
YaDeau
Jacques T
JT
Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York City, NY 10011, USA. yadeauj@hss.edu
LaSala
Vincent R
VR
Paroli
Leonardo
L
Kahn
Richard L
RL
Jules-Elysée
Kethy M
KM
Levine
David S
DS
Wukovits
Barbara L
BL
Lipnitsky
Jane Y
JY
D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D003000:Clonidine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D005528:Foot / Q000294:innervation* / Q000601:surgery; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D019637:Orthopedic Procedures; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D013997:Time Factors
D000700:Analgesics; D000779:Anesthetics, Local; D003000:Clonidine; D002045:Bupivacaine