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REGIONAL ANESTHESIA

The Short-Lasting Analgesia and Long-Term Antihyperalgesic Effect of Intrathecal Clonidine in Patients Undergoing Colonic Surgery

Department of Anesthesiology, University of Louvain, St. Luc Hospital, Brussels, Belgium

Address correspondence and reprint requests to Marc De Kock, MD, Department of Anesthesiology, St. Luc Hospital, av. Hippocrate 10-1821, 1200 Brussels, Belgium. Address e-mail to dekock{at}anes.ucl.ac.be.

In this study, we investigated the antihyperalgesic effect of clonidine after surgery. Sixty patients undergoing right colic resection were studied. Patients were randomized to receive prior to general anesthesia a 2-mL intrathecal (IT) injection of 300 µg of clonidine or saline, or 10 mg of bupivacaine. General anesthesia was achieved using a target concentration propofol infusion and monitored using bispectral index. Postoperative analgesia was provided by morphine IV given through a patient-controlled analgesia device. Postoperative analgesia was assessed by morphine requirements and visual analog scale pain scores at rest, cough, and movement during the first 72 h. Mechanical hyperalgesia was measured by von Frey filaments. Patients were questioned regarding residual pain at 2 wk,1, 6, and 12 mo. The patient-controlled analgesia morphine requirements were significantly smaller in the IT clonidine group (31.5 ± 12 versus 91 ± 25.5 and 43 ± 15 mg, respectively, in groups clonidine, saline, and bupivacaine: P < 0.05 at 72 postoperative hours). The area of hyperalgesia at 72 h was 3 ± 5 cm² in the clonidine group versus 90 ± 30 and 35 ± 20 cm² in the saline and bupivacaine groups (P < 0.05). At 6 mo, fewer patients in the clonidine group experienced residual pain than in the saline group (0 of 20 versus 6 of 20, P < 0.05). We conclude that both intraoperative spinal clonidine and bupivacaine improve immediate postoperative analgesia. IT clonidine was, however, more potent than IT bupivacaine to reduce postoperative secondary hyperalgesia.

This article has been cited by other articles:

				P. M. Lavand'homme, F. Roelants, H. Waterloos, V. Collet, and M. F. De Kock An Evaluation of the Postoperative Antihyperalgesic and Analgesic Effects of Intrathecal Clonidine Administered During Elective Cesarean Delivery Anesth. Analg., September 1, 2008; 107(3): 948 - 955. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999