JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (14) Citing Articles via Google Scholar Google Scholar Articles by Landau, R. Articles by Kern, C. Search for Related Content PubMed PubMed Citation Articles by Landau, R. Articles by Kern, C. Related Collections Pain Pharmacology Obstetrics

---

OBSTETRIC ANESTHESIA

The Dose-Sparing Effect of Clonidine Added to Ropivacaine for Labor Epidural Analgesia

Ruth Landau, MD^*, Eduardo Schiffer, MD^*, Michel Morales, MD, Georges Savoldelli, MD^*, and Christian Kern, MD^*

*Division d’Anesthésiologie, Département d’Anesthésiologie, Pharmacologie et Soins Intensifs de Chirurgie (APSIC), and Clinique d’Obstétrique, Département de Gynécologie et Obstétrique, Hôpitaux Universitaires de Genève (HUG), Genève, Suisse

Address correspondence and reprint requests to Ruth Landau, MD, Division d’Anesthésiologie, APSIC, Hôpitaux Universitaires de Genève (HUG), Rue Micheli-du-Crest 12, 1211 Genève 14, Switzerland. Address e-mail to ruth.landau{at}hcuge.ch

To determine the effects of clonidine with ropivacaine during epidural labor analgesia, we studied 66 nulliparous women in early active labor. Women were randomized to receive ropivacaine 0.1% 8 mL plus 75 µg of clonidine (Group 1), ropivacaine 0.2% 8 mL plus 0.5 mL of NaCl 0.9% (Group 2), or ropivacaine 0.2% 8 mL plus 75 µg of clonidine (Group 3) 5 min after a bupivacaine 7.5 mg with epinephrine 15 µg test dose. Upon request, additional analgesia with ropivacaine 0.1% 8 mL followed by ropivacaine 0.2% 8 mL/h was administered. With clonidine, duration of analgesia was increased (132 ± 48 min [Group 1] and 154 ± 42 min [Group 3] versus 91 ± 44 min [Group 2]; P < 0.05), and total ropivacaine dose over the first 4 h was significantly reduced (40.5 ± 15 mg [Group 1] and 47.0 ± 16 mg [Group 3] versus 72.5 ± 18 mg [Group 2]; P < 0.01). The incidence of more profound motor block was more frequent in Group 2 (P < 0.05). Although there was a trend for more women receiving clonidine to require ephedrine for treatment of hypotension, this did not seem to have an impact on fetal outcome or incidence of cesarean deliveries for nonreassuring fetal heart rate tracings. This study demonstrates the dose-sparing effect of clonidine when added to ropivacaine.

IMPLICATIONS: The effect of adding 75 µg of clonidine to ropivacaine for epidural labor analgesia was studied. Clonidine increased analgesia duration and produced dose sparing compared with ropivacaine alone. Despite a tendency for hypotension in women receiving clonidine, there was no apparent effect on delivery mode or neonatal outcome.

This article has been cited by other articles:

				A. Casati, F. Vinciguerra, G. Cappelleri, G. Aldegheri, G. Fanelli, M. Putzu, and J. E. Chelly Adding Clonidine to the Induction Bolus and Postoperative Infusion During Continuous Femoral Nerve Block Delays Recovery of Motor Function After Total Knee Arthroplasty Anesth. Analg., March 1, 2005; 100(3): 866 - 872. [Abstract] [Full Text] [PDF]

				C. Missant, A. Teunkens, E. Vandermeersch, and M. Van de Velde Intrathecal clonidine prolongs labour analgesia but worsens fetal outcome: a pilot study: [L'administration intrathecale de clonidine prolonge l'analgesie du travail obstetrical, mais compromet l'evolution foetale: une etude pilote] Can J Anesth, August 1, 2004; 51(7): 696 - 701. [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