The effect of clonidine on intra-operative requirements of fentanyl during combined epidural/general anaesthesia

Anaesthesia. 1994 Nov;49(11):999-1002. doi: 10.1111/j.1365-2044.1994.tb04323.x.

Abstract

The study evaluates the analgesic effects of epidural clonidine in patients undergoing abdominal hysterectomy under combined epidural/general anaesthesia. Forty ASA 1-2 patients were divided into two groups who received epidurally either clonidine 300 micrograms (group 1) or placebo (group 2). Anaesthesia was maintained with oxygen/nitrous oxide, a midazolam infusion, vecuronium, and boluses of fentanyl 100 micrograms administered as needed to maintain cardiovascular stability. The mean (SD) intraoperative fentanyl requirements were 2.05 (0.18) and 3.66 (0.3) micrograms.kg-1.h-1 for groups 1 and 2 respectively (p < 0.001). Patients in Group 1 had a lower heart rate after tracheal intubation and surgical incision (p < 0.02). In the recovery room, pain intensity was lower in group 1 (p < 0.003) and the mean (SD) time until analgesia request was increased from 48.5 (8.4) min in group 2 to 235.7 (33.2) min in group 1 (p < 0.001). Our results demonstrate that epidural clonidine produces decreased fentanyl requirements, improved cardiovascular stability, reduced pain intensity and effective postoperative analgesia in the recovery room.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia, Epidural
  • Anesthesia Recovery Period
  • Anesthesia, Epidural*
  • Anesthesia, General*
  • Clonidine*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Fentanyl*
  • Heart Rate / drug effects
  • Humans
  • Hysterectomy
  • Pain, Postoperative / prevention & control

Substances

  • Clonidine
  • Fentanyl