Evaluación del efecto de clonidina intratecal para disminuir el dolor de hombro durante laparoscopía bajo raquianestesia
Evaluation of the effect of intrathecal clonidine to decrease shoulder tip pain in laparoscopy under spinal anaesthesia.
Ghodki PS, Sardesai SP, Thombre SK.
Lecturer, Department of Anaesthesiology, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune, India.
Indian J Anaesth. 2010 May;54(3):231-4. doi: 10.4103/0019-5049.65370.
Abstract
Sixty ASA grade I/II patients scheduled for elective short laparoscopic procedures under spinal anaesthesia were divided into two groups of 30 each. The first group (group C) received 3.5 ml of hyperbaric bupivacaine with 30 mcg of clonidine. The second group (group B) received plain bupivacaine 3.5 ml. Till date, the limiting factor for use of spinal anaesthesia for laparoscopy was patient's discomfort due to shoulder tip pain. From our study it can be concluded that bupivacaine along with clonidine in low doses provides good sedation and analgesia in intraoperative and post-operative period and at the same time abolishes shoulder tip pain during laparoscopic procedures. In addition, no significant changes in haemodynamics occur with the low dose of clonidine used.
KEYWORDS: Bupivacaine, clonidine, intrathecal, laparoscopy, shoulder tip pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933482/
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2010;volume=54;issue=3;spage=231;epage=234;aulast=Ghodki;type=2
Comparación de dexmedetomidina, clonidina y fentanilo intratecales como adyuvantes de bupivacaína hiperbárica para cirugía de extremidades inferiores: Estudio doble ciego controlado.
A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study.
Mahendru V, Tewari A, Katyal S, Grewal A, Singh MR, Katyal R.
Department of Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):496-502. doi: 10.4103/0970-9185.119151.
Abstract
BACKGROUND:Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. Dexmedetomidine, the highly selective 2 adrenergic agonist is a new neuraxial adjuvant gaining popularity. SETTINGS AND DESIGN: The study was conducted in prospective, double blind manner. It included 120 American Society of Anesthesiology (ASA) class I and II patients undergoing lower limb surgery under spinal anesthesia after approval from hospital ethics committee with written and informed consent of patients. MATERIALS AND METHODS:The patients were randomly allocated into four groups (30 patients each). Group BS received 12.5 mg hyperbaric bupivacaine with normal saline, group BF received 12.5 mg bupivacaine with 25 g fentanyl, group BC received 12.5 mg of bupivacaine supplemented 30 g clonidine, and group BD received 12.5 mg bupivacaine plus 5 g dexmedetomidine. The onset time to reach peak sensory and motor level, the regression time of sensory and motor block, hemodynamic changes, and side effects were recorded. RESULTS: Patients in Group BD had significantly longer sensory and motor block times than patients in Groups BC, BF, and BS with Groups BC and BF having comparable duration of sensory and motor block. The mean time of two segment sensory block regression was 147 ± 21 min in Group BD, 117 ± 22 in Group BC, 119 ± 23 in Group BF, and 102 ± 17 in Group BS (P > 0.0001). The regression time of motor block to reach modified Bromage zero (0) was 275 ± 25, 199 ± 26, 196 ± 27, 161 ± 20 in Group BD, BC, BF, and BS, respectively (P > 0.0001). The onset times to reach T8 dermatome and modified Bromage 3 motor block were not significantly different between the groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. CONCLUSIONS:Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand of rescue analgesics in 24 h as compared to clonidine, fentanyl, or lone bupivacaine.
KEYWORDS: adrenoreceptor agonist, bupivacaine, clonidine, dexmedetomidine, fentanyl, spinal anesthesia, α2
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819844/
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=4;spage=496;epage=502;aulast=Mahendru;type=2
Reporte de caso: anestesia espinal multimodal en paciente
pediátrico con vía aérea difícil
William Diaz Herrera, Hector Fidel Osorio Zambranoy Miguel Francisco Sandoval Cabrerac
Rev Colomb Anestesiol. 2 0 1 3;4 1(3):218-222
http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90217349&pident_usuario=0&pcontactid=&pident_revista=341&ty=143&accion=L&origen=clysa%20&web=http://www.revcolanest.com.co&lan=es&fichero=341v41n03a90217349pdf001.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Evaluation of the effect of intrathecal clonidine to decrease shoulder tip pain in laparoscopy under spinal anaesthesia.
Ghodki PS, Sardesai SP, Thombre SK.
Lecturer, Department of Anaesthesiology, Shrimati Kashibai Navale Medical College and General Hospital, Narhe, Pune, India.
Indian J Anaesth. 2010 May;54(3):231-4. doi: 10.4103/0019-5049.65370.
Abstract
Sixty ASA grade I/II patients scheduled for elective short laparoscopic procedures under spinal anaesthesia were divided into two groups of 30 each. The first group (group C) received 3.5 ml of hyperbaric bupivacaine with 30 mcg of clonidine. The second group (group B) received plain bupivacaine 3.5 ml. Till date, the limiting factor for use of spinal anaesthesia for laparoscopy was patient's discomfort due to shoulder tip pain. From our study it can be concluded that bupivacaine along with clonidine in low doses provides good sedation and analgesia in intraoperative and post-operative period and at the same time abolishes shoulder tip pain during laparoscopic procedures. In addition, no significant changes in haemodynamics occur with the low dose of clonidine used.
KEYWORDS: Bupivacaine, clonidine, intrathecal, laparoscopy, shoulder tip pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933482/
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2010;volume=54;issue=3;spage=231;epage=234;aulast=Ghodki;type=2
Comparación de dexmedetomidina, clonidina y fentanilo intratecales como adyuvantes de bupivacaína hiperbárica para cirugía de extremidades inferiores: Estudio doble ciego controlado.
A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study.
Mahendru V, Tewari A, Katyal S, Grewal A, Singh MR, Katyal R.
Department of Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
J Anaesthesiol Clin Pharmacol. 2013 Oct;29(4):496-502. doi: 10.4103/0970-9185.119151.
Abstract
BACKGROUND:Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. Dexmedetomidine, the highly selective 2 adrenergic agonist is a new neuraxial adjuvant gaining popularity. SETTINGS AND DESIGN: The study was conducted in prospective, double blind manner. It included 120 American Society of Anesthesiology (ASA) class I and II patients undergoing lower limb surgery under spinal anesthesia after approval from hospital ethics committee with written and informed consent of patients. MATERIALS AND METHODS:The patients were randomly allocated into four groups (30 patients each). Group BS received 12.5 mg hyperbaric bupivacaine with normal saline, group BF received 12.5 mg bupivacaine with 25 g fentanyl, group BC received 12.5 mg of bupivacaine supplemented 30 g clonidine, and group BD received 12.5 mg bupivacaine plus 5 g dexmedetomidine. The onset time to reach peak sensory and motor level, the regression time of sensory and motor block, hemodynamic changes, and side effects were recorded. RESULTS: Patients in Group BD had significantly longer sensory and motor block times than patients in Groups BC, BF, and BS with Groups BC and BF having comparable duration of sensory and motor block. The mean time of two segment sensory block regression was 147 ± 21 min in Group BD, 117 ± 22 in Group BC, 119 ± 23 in Group BF, and 102 ± 17 in Group BS (P > 0.0001). The regression time of motor block to reach modified Bromage zero (0) was 275 ± 25, 199 ± 26, 196 ± 27, 161 ± 20 in Group BD, BC, BF, and BS, respectively (P > 0.0001). The onset times to reach T8 dermatome and modified Bromage 3 motor block were not significantly different between the groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic. CONCLUSIONS:Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand of rescue analgesics in 24 h as compared to clonidine, fentanyl, or lone bupivacaine.
KEYWORDS: adrenoreceptor agonist, bupivacaine, clonidine, dexmedetomidine, fentanyl, spinal anesthesia, α2
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819844/
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2013;volume=29;issue=4;spage=496;epage=502;aulast=Mahendru;type=2
Reporte de caso: anestesia espinal multimodal en paciente
pediátrico con vía aérea difícil
William Diaz Herrera, Hector Fidel Osorio Zambranoy Miguel Francisco Sandoval Cabrerac
Rev Colomb Anestesiol. 2 0 1 3;4 1(3):218-222
http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90217349&pident_usuario=0&pcontactid=&pident_revista=341&ty=143&accion=L&origen=clysa%20&web=http://www.revcolanest.com.co&lan=es&fichero=341v41n03a90217349pdf001.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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