[Epidural clonidine or dexmedetomidine for post-cholecystectomy analgesia and sedation.].
OBJECTIVE
Clonidine and dexmedetomidine are alpha2-adrenergic agonists with analgesic proprieties which potentiate local anesthetic effects when epidurally administered. The goal of this study was to evaluate the analgesia and sedation promoted by clonidine or dexmedetomidine associated to epidural ropivacaine, in the postoperative period of subcostal cholecystectomy.


METHODS
Forty patients of both gender participated in this randomized double-blind study , aged 18 to 50 years, weighing 50 to 100 kg, physical status ASA I or II, submitted to subcostal cholecystectomy. The subjects were distributed in two groups: Clonidine (CG), receiving clonidine (1 mL = 150 microg) associated to 0.75% epidural ropivacaine (20 mL); Dexmedetomidine (DG), receiving dexmedetomidine (2 microg.kg-1) associated to 0.75% epidural ropivacaine (20 mL). Analgesia and sedation were evaluated 2, 6 and 24 hours anesthetic recovery.


RESULTS
Both groups present some grade of sedation in the moments 2 and 6 hours , with statistically significant difference between the two moments for the dexmedetomidine group. There has been analgesia in both groups, especially at 2 and 6 hours. There have been statistically significant difference among periods of 2, 6 and 24 hours in the dexmedetomidine group; in the clonidine group, this statistically significant difference was observed between the periods of 2 and 6 hours and between 2 and 24 hours.


CONCLUSIONS
Our results allowed to conclude that the association of clonidine or dexmedetomidine to 0.75% ropivacaine induces analgesia and sedation in 2 and 6 hours after anesthetic recovery in patients submitted to subcostal cholecystectomy and that clonidine promotes more prolonged analgesia.
Vieira
Antônio Mauro
AM
Departamento de Fisiologia, Morfologia e Patologia, Faculdade de Ciências Médicas de Pouso Alegre, Universidade do Vale do Sapucaí.
Schnaider
Taylor Brandão
TB
Brandão
Antônio Carlos Aguiar
AC
Pereira
Flávio Aparecido
FA
Costa
Everaldo Donizeti
ED
Fonseca
Carlos Eduardo Povoa
CE