Effect of clonidine on the cutaneous silent period during spinal anesthesia

作     者：Sandra Graf Zupcic Miroslav Zupcic Viktor Duzel Tatjana imurina Milan Miloevi Silvio Basic Vladimira Vuletic Leonardo Kapural 

作者机构：Clinic of Neurology Clinical Hospital Centre Rijeka Faculty of Medicine J.J.Strossmayer University Clinic of Anesthesiology and Intensive Care Medicine Clinical Hospital Centre Rijeka Faculty of Medicine University of Rijeka Department of Anaesthesia Barking Havering and Redbridge University Hospitals NHS Trust Department of Health Studies University of Zadar Department of Anesthesiology and Intensive Care Medicine General Hospital Zadar University of Zagreb School of Medicine Andrija Stampar School of Public Health WHO Collaborative Centre for Occupational Health Department of Neurology Clinical Hospital Dubrava Center for Clinical Research Winston Salem 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2018年第6卷第16期

页      面：1136-1145页

核心收录：

学科分类：10[医学] 

主　　题：Clonidine Local anesthetics Nerve fibers Spinal anesthesia Reflex 

摘      要：AIM To investigate the effect of clonidine on the cutaneous silent period(CSP) during spinal anesthesia. METHODS A total of 67 adult patients were included in this randomized, prospective, single-center, double-blind trial. They did not have neurological disorders and were scheduled for inguinal hernia repair surgery. This trial was registered on ***(NTC03121261). The patients were randomized into two groups with regards to the intrathecally administered solution:(1) 15 mg of 0.5% levobupivacaine with 50 μg of 0.015% clonidine, or(2) 15 mg of 0.5% levobupivacaine alone. There were 34 patients in the levobupivacaine-clonidine(LC) group and 33 patients in the levobupivacaine(L) group. CSP and its latency were measured four times: prior to the subarachnoid block(SAB), after motor block regression to the 0 level of the Bromage scale, with ongoing sensory blockade, and both 6 and 24 h after *** Only data from 30 patients in each group were analyzed. There were no significant differences between the groups investigated preoperatively and after 24 h. The CSP of the L group at the time point when the Bromage scale was 0 was 44.8 ± 8.1 ms, while in the LC group it measured 40.2 ± 3.8 ms(P = 0.007). The latency in the L group at the time point when the Bromage scale was 0 was 130.3 ± 10.2 ms, and in the LC group it was 144.7 ± 8.3 ms(P 0.001). The CSP of the L group after 6 h was 59.6 ± 9.8 ms, while in the LC group it was 44.5 ± 5.0 ms(P 0.001). The latency in the L group after 6 h was 110.4 ± 10.6 ms, while in LC group it was 132.3 ± 9.7 ms(P 0.001).CONCLUSION Intrathecal addition of clonidine to levobupivacaine for SAB in comparison with levobupivacaine alone resultsin a diminished inhibitory tonus and shortened CSP.