JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 2008; 107:948-955
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31817f1595
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Lavand’homme, P. M.
Right arrow Articles by De Kock, M. F.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lavand’homme, P. M.
Right arrow Articles by De Kock, M. F.
Related Collections
Right arrow Obstetrics
Right arrow Pain Mechanisms
Right arrow Pain Medicine
Right arrow Regional Anesthesia
Right arrow Pain
Right arrow Pharmacology

OBSTETRIC ANESTHESIOLOGY

An Evaluation of the Postoperative Antihyperalgesic and Analgesic Effects of Intrathecal Clonidine Administered During Elective Cesarean Delivery

Patricia M. Lavand’homme, MD, PhD, Fabienne Roelants, MD, Hilde Waterloos, RN, Valerie Collet, MSc, and Marc F. De Kock, MD, PhD

From the Department of Anesthesiology, St Luc Hospital Medical School, Université Catholique de Louvain, Brussels, Belgium.

Address correspondence and reprint requests to P. Lavand’homme, Department of Anesthesiology, St Luc Hospital, Université Catholique de Louvain, Av Hippocrate 10–1821, 1200 Brussels, Belgium. Address e-mail to lavandhomme{at}anes.ucl.ac.be.

Abstract

BACKGROUND: Intrathecal clonidine improves intraoperative anesthesia and postoperative analgesia after cesarean delivery. Clonidine also possesses antihyperalgesic properties. Hyperalgesia contributes to postoperative pain and may be associated with increased risk of chronic pain after surgery. In this study, we evaluated the postoperative antihyperalgesic effect of intrathecal clonidine after caesarean delivery.

METHODS: Ninety-six parturients undergoing elective cesarean delivery were randomly assigned to receive intrathecal bupivacaine-sufentanil (BS group), bupivacaine-sufentanil-clonidine 75 µg (BSC group), or bupivacaine-clonidine 150 µg (BC group). The primary outcome was the extent and the incidence of periincisional punctate mechanical hyperalgesia as assessed by response to application of a von Frey filament at 24 and 48 h after cesarean delivery. Postoperative morphine requirements and pain scores, as well as residual pain at 1, 3, and 6 mo, were also assessed.

RESULTS: The BC group had a significantly reduced area of periincisional hyperalgesia at 48 h (median, 25th–75th percentiles): 1.0 (1.0 – 3.3) cm2 vs 9.5 (5.0–14.0) cm2 in the BS group vs 5.0 (2.5–12.3) cm2 in the BSC group (P = 0.02 with the BS group). The incidence of hyperalgesia at 48 h was also lower in the BC group: 16% vs 41% in the BS group vs 34% in the BSC group (P = 0.03 with BS group). Postoperative morphine consumption, pain scores, and incidence and intensity of residual pain did not differ among groups.

CONCLUSIONS: Intrathecal clonidine 150 µg combined with bupivacaine had a postoperative antihyperalgesic effect expressed as a significant reduction in the extent and incidence of periincisional punctate mechanical hyperalgesia at 48 h after elective cesarean delivery compared with intrathecal bupivacaine-sufentanil and intrathecal clonidine 75 µg-bupivacaine-sufentanil.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.