20282
document
Spinal 2-chloroprocaine : the effect of added clonidine . Preservative-free 2-chloroprocaine ( 2-CP ) is being investigated for short-acting spinal anesthesia . Clonidine improves the quality of spinal bupivacaine and ropivacaine , but in traditional doses ( 1-2 microg/kg ) it produces systemic side effects . It has not been studied in combination with 2-CP . In this double-blind , randomized crossover study , we compared spinal 2-CP ( 30 mg ) with and without clonidine ( 15 microg ) in eight volunteers . Pinprick anesthesia , motor strength , tolerance to electrical stimulation and thigh tourniquet , and time to ambulation were assessed . Peak block height was similar between 2-CP ( T8 [ range , T6 to L2 ] ) and 2-CP with clonidine ( T8 [ range , T4 to T11 ] ) ( P = 0.57 ) . Sensory anesthesia was prolonged with clonidine at L1 ( 51 +/- 23 min versus 76 +/- 11 min ; P = 0.002 ) , as was complete block regression ( 99 +/- 18 min versus 131 +/- 15 min ; P = 0.001 ) . Lower extremity motor blockade was increased with clonidine ( return to baseline Bromage score : 65 +/- 13 min versus 79 +/- 19 min , P = 0.004 ; return to 90 % gastrocnemius strength : P = 0.003 ) . Clonidine increased tourniquet tolerance from 33 to 45 min ( P = 0.06 ) and increased time to ambulation , spontaneous voiding , and discharge ( 99 +/- 18 min versus 131 +/- 15 min for all ; P = 0.001 ) . There were no differences in hemodynamic measurements , and no subject reported transient neurologic symptoms . We conclude that small-dose clonidine increases the duration and improves the quality of 2-CP spinal anesthesia without systemic side effects .
20283
Intervention_Pharmacological
2-chloroprocaine
20284
Intervention_Pharmacological
clonidine
20285
Intervention_Pharmacological
2-chloroprocaine ( 2-CP )
20286
Intervention_Pharmacological
Clonidine
20287
Intervention_Pharmacological
bupivacaine
20288
Intervention_Pharmacological
ropivacaine
20289
Intervention_Pharmacological
2-CP
20290
Intervention_Pharmacological
spinal 2-CP
20291
Intervention_Pharmacological
with and without clonidine
20292
Intervention_Pharmacological
clonidine
20293
Intervention_Pharmacological
clonidine
20294
Intervention_Pharmacological
Clonidine
20295
Intervention_Pharmacological
clonidine
20296
Outcome_Other
spinal bupivacaine
20297
Outcome_Other
ropivacaine
20298
Outcome_Other
Pinprick anesthesia
20299
Outcome_Physical
, motor strength , tolerance to electrical stimulation and thigh tourniquet , and
20300
Outcome_Other
time to ambulation
20301
Outcome_Other
Peak block height
20302
Outcome_Other
Sensory anesthesia
20303
Outcome_Other
complete block regression
20304
Outcome_Other
Lower extremity motor blockade
20305
Outcome_Physical
gastrocnemius strength :
20306
Outcome_Other
tourniquet tolerance
20307
Outcome_Other
time to ambulation , spontaneous voiding , and discharge
20308
Outcome_Physical
hemodynamic measurements
20309
Outcome_Physical
transient neurologic symptoms
20310
Outcome_Other
quality of 2-CP spinal anesthesia
20311
Outcome_Adverse-effects
systemic side effects
20312
Participant_Sample-size
eight