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clonidine epidural

Anouar Jarraya, Sahar Elleuch, Jawhar Zouari, Mohamed Smaoui, Sofiene Laabidi, Kamel Kolsi
The aim of the study was to evaluate the efficacy of clonidine in association with fentanyl as an additive to bupivacaine 0.25% given via single shot caudal epidural in pediatric patients for postoperative pain relief. In the present prospective randomized double blind study, 40 children of ASA-I-II aged 1-5 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg and clonidine 1μg/kg (group I) or bupivacaine 0...
2016: Pan African Medical Journal
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
Rachna Prasad, Rs Raghavendra Rao, Ashwini Turai, P Prabha, R Shreyavathi, Karuna Harsoor
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) anaesthesia is being increasingly used for effective post-operative analgesia. This study was designed to evaluate the effect of epidural clonidine on characteristics of spinal anaesthesia for gynaecological surgeries. METHODS: This was a prospective randomised, double-blind, controlled study involving sixty patients belonging to American Society of Anesthesiologists Physical Status I and II who underwent gynaecological surgeries were randomly divided into clonidine (C) group and saline (S) group of thirty each...
June 2016: Indian Journal of Anaesthesia
Safiya I Shaikh, Sarala B Mahesh
BACKGROUND AND AIMS: Alpha (α-2) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. A prospective randomized double-blind study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to bupivacaine with special emphasis on their quality of analgesia, sedation and the ability to provide the smooth intra-operative and postoperative course...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Vigya Goyal, Jyotsna Kubre, Krishnaprabha Radhakrishnan
CONTEXT: Postoperative pain management is becoming an integral part of anesthesia care. Various techniques of pediatric pain relief have been designed among which the most commonly practiced is caudal epidural block. Several adjuvants have been used to prolong the duration of caudal analgesia such as clonidine, neostigmine, ketamine, opioids, and ephedrine. We have designed the study using dexmedetomidine as an adjuvant to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, postoperative sedation, and any adverse effects in children...
May 2016: Anesthesia, Essays and Researches
Pramila Soni
BACKGROUND: Better adjuvants for epidural analgesia are still evolving. Dexmedetomidine that is alpha-2 agonist can be used as an adjuvant in epidural analgesia and anesthesia. AIMS: The aim of this study was to compare the effect of dexmedetomidine versus clonidine in combination with ropivacaine in epidural anesthesia on intraoperative and postoperative analgesia, to find out the better adjuvant for regional anesthesia. SETTINGS AND DESIGN: Randomized control trial...
May 2016: Anesthesia, Essays and Researches
Dinesh K Choudhry, B Randall Brenn, Karen Sacks, Kirk Reichard
BACKGROUND: Pain following Nuss procedure is severe and its management is challenging. Many different pain treatment modalities are currently being used, but none of them have been found to be ideal. AIM: In this retrospective review, we compare our current multimodal approach, which involves continuous ropivacaine infusion through chest wall catheters (CWC), intravenous patient-controlled analgesia (IV-PCA), and adjunctive medications (gabapentin and clonidine), with the technique that we used in the past, the thoracic epidural catheter (TEC)...
June 2016: Paediatric Anaesthesia
Sangeeta Agarwal Bansal, Yogesh Tilkar, Sanjeevani Karmalkar
No abstract text is available yet for this article.
March 2016: Indian Journal of Anaesthesia
Shivakumar M Channabasappa, Gopinath H Venkatarao, Shobha Girish, Nandakishore K Lahoti
CONTEXT: Alpha-2 adrenergic agonists clonidine and dexmedetomidine, are well known to produce analgesia through an opioid independent mechanism. Alpha-2 agonists are used as an adjuvant to local anesthetic agents to extend the duration of spinal, epidural and brachial plexus blocks. AIMS: We compared clonidine and dexmedetomidine as an adjuvant to Ropivacaine in cervical epidural anesthesia (CEA) with respect to onset and duration of sensory block, duration of analgesia and adverse effects...
January 2016: Anesthesia, Essays and Researches
Sruthi Arunkumar, V R Hemanth Kumar, N Krishnaveni, M Ravishankar, Velraj Jaya, M Aruloli
BACKGROUND: The quality and duration of analgesia is improved when a local anesthetic is combined with alpha 2 adrenergic agonist. Though, the effects of clonidine on local anesthetics have been extensively studied, there are limited studies demonstrating the effects of epidural dexmedetomidine on local anesthetics. The aim of our study is to compare the effect of clonidine and dexmedetomidine when used as an adjuvant to epidural ropivacaine in lower abdominal and lower limb surgeries...
October 2015: Saudi Journal of Anaesthesia
Karthik Krishnamoorthy, Saravanan Ravi, Ilango Ganesan
OBJECTIVE: The objective of this study is to evaluate the efficacy of epidural clonidine in intra and postoperative analgesia, the level of sedation caused by clonidine and monitor its side effects. MATERIALS AND METHODS: Forty patients of ASA1 & ASA2 scheduled for lower limb orthopaediac surgeries were chosen for the study. Study group received 50μg of clonidine diluted to 1ml along with first dose of epidural injection and Control group received 1ml of normal saline along with first dose of epidural...
September 2015: Journal of Clinical and Diagnostic Research: JCDR
Justin M Poltak, Frederick C Cobey, John G Augoustides, Christopher W Connors
INTRODUCTION: Transapical transcatheter aortic valve replacement is an option for patients who are not candidates for traditional aortic valve surgery but have severe aortic stenosis and unfavorable ileo-femoral anatomy. Epidural analgesia in these cases has been associated with improved morbidity and mortality. The following manuscript presents the findings of an initial clinical experience employing paravertebral analgesia for patients undergoing transapical transcatheter aortic valve replacement...
2015: Heart, Lung and Vessels
Ayman Abd Al-Maksoud Yousef, Ashraf Mohamed Atef, Waleed Mohamed Awais
BACKGROUND: The analgesic and sedative effect of clonidine explain its common use as adjuvant in regional anesthesia, however the hemodynamic instability associated with its neuroaxial administration is the major drawback. Our study hypothesis is to compare the hemodynamic and analgesic effect of epidural fentanyl in comparison to meperidine when added to clonidine in patients undergoing lower limbs orthopedic surgery using combined spinal-epidural anesthesia. METHODS: One hundred thirty five ASA physical status I or II patients were recruited for lower limb orthopedic surgery...
October 14, 2015: BMC Anesthesiology
Fabienne Roelants, Patricia Lavand'homme
BACKGROUND: Adjuvants to local anaesthetics for epidural labour analgesia are useful if they reduce side-effects or personnel requirements. Epidural clonidine improves analgesia and provides a significant local anaesthetic-sparing effect. OBJECTIVE: To compare the number of rescue doses administered by the anaesthesiologist when clonidine or sufentanil is added to epidural ropivacaine. DESIGN: A randomised double-blind trial. SETTING: Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, from June 2009 to June 2010...
November 2015: European Journal of Anaesthesiology
George A Chalkiadis, David Sommerfield, Janette Low, Francesca Orsini, Stephanie J Dowden, Michelle Tay, Sueann Penrose, Marinis Pirpiris, H Kerr Graham
AIM: To compare diazepam use, muscle spasm, analgesia, and side effects when clonidine or fentanyl are added to epidural bupivacaine in children with cerebral palsy after multilevel orthopaedic surgery. METHOD: Fifty children were prospectively randomized to receive clonidine (n=24, mean age 10y 10mo [SD 2y 11mo]) or fentanyl (n=26, mean age 10y 11mo [SD 2y 10mo]). RESULTS: There was no difference in primary outcome measures: median diazepam use (fentanyl 0, interquartile range [IQR] 0-0; clonidine 0, IQR 0-0; p=0...
April 2016: Developmental Medicine and Child Neurology
K Leslie, D McIlroy, J Kasza, A Forbes, A Kurz, J Khan, C S Meyhoff, R Allard, G Landoni, X Jara, G Lurati Buse, K Candiotti, H-S Lee, R Gupta, T VanHelder, W Purayil, S De Hert, T Treschan, P J Devereaux
BACKGROUND: We assessed associations between intraoperative neuraxial block and postoperative epidural analgesia, and a composite primary outcome of death or non-fatal myocardial infarction, at 30 days post-randomization in POISE-2 Trial subjects. METHODS: 10 010 high-risk noncardiac surgical patients were randomized aspirin or placebo and clonidine or placebo. Neuraxial block was defined as intraoperative spinal anaesthesia, or thoracic or lumbar epidural anaesthesia...
January 2016: British Journal of Anaesthesia
Alaa A Abd-Elsayed, Maged Guirguis, Mark S DeWood, Sherif S Zaky
BACKGROUND: Alpha-2 adrenergic agonists produce safe and effective analgesia, but most investigations studying the analgesic effect of alpha-2 adrenoceptor agonists postoperatively included previous or concomitant administration of other analgesics. Because clonidine potentiates the effect of these drugs, its own intrinsic analgesic effect has been difficult to establish. This study was designed to compare the intraoperative and postoperative effects of epidural clonidine vs bupivacaine for patients undergoing lower abdominal surgery...
2015: Ochsner Journal
Kethy M Jules-Elysee, Amanda K Goon, Geoffrey H Westrich, Douglas E Padgett, David J Mayman, Amar S Ranawat, Chitranjan S Ranawat, Yi Lin, Richard L Kahn, Devan D Bhagat, Enrique A Goytizolo, Yan Ma, Shane C Reid, Jodie Curren, Jacques T YaDeau
BACKGROUND: The optimal postoperative analgesia after primary total hip arthroplasty remains in question. This randomized, double-blind, placebo-controlled study compared the use of patient-controlled epidural analgesia (PCEA) with use of a multimodal pain regimen including periarticular injection (PAI). We hypothesized that PAI would lead to earlier readiness for discharge, decreased opioid consumption, and lower pain scores. METHODS: Forty-one patients received PAI, and forty-three patients received PCEA...
May 20, 2015: Journal of Bone and Joint Surgery. American Volume
Mi Geum Lee, Dong Kyu Lee, Billy K Huh, Sang Sik Choi, Hee Zoo Kim, Byung Gun Lim, Hong Soon Kim, Yun Suk Choi, Won Seok Hur, Mi Kyoung Lee
Resiniferatoxin (RTX) is an ultrapotent synthetic TRPV1 (transient receptor potential vanilloid subtype 1) agonist with significant initial transient hyperalgesia followed by a prolonged analgesic effect in response to thermal stimulus. Using a rat model of neuropathic pain, we evaluated the effect of pretreatment with clonidine-which has been shown to relieve intradermal capsaicin-induced hyperalgesia-on the initial hyperalgesic response and the thermal analgesic property of RTX. Thirty-six male rats were divided into 6 treatment groups (n=6 each):RTX 500 ng, RTX 1 μg, clonidine 20 μg (Cl), Cl+RTX 500 ng, Cl+RTX 1 μg, or normal saline 20 μL (control)...
2015: Acta Medica Okayama
Tapan J Parikh, Vishal Divecha, Divyang Dalwadi
BACKGROUND: Many adjuvants are used to increase the efficacy of epidural local anesthetics for postoperative analgesia. AIMS: The aim was to compare the efficacy of epidural morphine (0.1 mg/kg) and clonidine (2 μg/kg) with bupivacaine (0.125%) for postoperative analgesia in abdominal surgeries. SETTINGS AND DESIGN: Double-blind retrospective randomized study. METHODOLOGY: All the patients (n = 60) varying from age group belonging to American Society of Anesthesiologists I-II were randomly allocated to receive epidural analgesia Group A - Morphine (0...
January 2015: Anesthesia, Essays and Researches
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