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The analgesic effect of interscalene block using clonidine as an analgesic for shoulder arthroscopy.
Anesth Analg. 2003 Jan; 96(1):260-2, table of contents.A&A

Abstract

Used as the sole analgesic, clonidine produces analgesia after central neural blockade and intraarticular injection but not after axillary block. In this study, we sought to determine whether interscalene clonidine induces analgesia for shoulder arthroscopy. Forty patients scheduled for shoulder arthroscopy were prospectively included in this double-blinded study. Using a nerve stimulator technique, an interscalene catheter was inserted. The patients were randomly divided into two groups. The interscalene group (n = 20) received clonidine 150 micro g in 15 mL of saline through the catheter and 1 mL of subcutaneous saline, and the systemic group (n = 20) received 15 mL of saline through the catheter and clonidine 150 micro g (1 mL) subcutaneously. All patients underwent general anesthesia for surgery. On completion of arthroscopy, all patients received, via a patient-controlled analgesia, on demand a bolus of 8 mL of ropivacaine 0.2% through the catheter with a 1-h lockout period. Postoperative pain was measured every 4 h using the visual analog scale (VAS) for 24 h. Additional postoperative analgesia was available with parenteral nalbuphine if required until VAS < 3. VAS scores in the recovery room were significantly higher in the systemic group compared with the interscalene group (P < 0.0001). Analgesic duration was significantly longer in the interscalene group (P < 0.00001), and ropivacaine consumption was significantly less than in the systemic group (P < 0.0001). No significant difference was observed between groups for nalbuphine consumption. Side effects were comparable in the two groups.

IMPLICATIONS

Clonidine administered via an interscalene catheter enhanced analgesia compared with systemic administration. Nevertheless, the adverse effect of clonidine at this dose limits its use for routine management for postoperative analgesia.

Authors+Show Affiliations

Clinique chirurgicale Bordeaux-Mérignac, France. henri.iskandar@wanadoo.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12505963

Citation

Iskandar, Henri, et al. "The Analgesic Effect of Interscalene Block Using Clonidine as an Analgesic for Shoulder Arthroscopy." Anesthesia and Analgesia, vol. 96, no. 1, 2003, 260-2, table of contents.
Iskandar H, Benard A, Ruel-Raymond J, et al. The analgesic effect of interscalene block using clonidine as an analgesic for shoulder arthroscopy. Anesth Analg. 2003;96(1):260-2, table of contents.
Iskandar, H., Benard, A., Ruel-Raymond, J., Cochard, G., & Manaud, B. (2003). The analgesic effect of interscalene block using clonidine as an analgesic for shoulder arthroscopy. Anesthesia and Analgesia, 96(1), 260-2, table of contents.
Iskandar H, et al. The Analgesic Effect of Interscalene Block Using Clonidine as an Analgesic for Shoulder Arthroscopy. Anesth Analg. 2003;96(1):260-2, table of contents. PubMed PMID: 12505963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The analgesic effect of interscalene block using clonidine as an analgesic for shoulder arthroscopy. AU - Iskandar,Henri, AU - Benard,Antoine, AU - Ruel-Raymond,Joelle, AU - Cochard,Gyslaine, AU - Manaud,Bertrand, PY - 2002/12/31/pubmed PY - 2003/1/22/medline PY - 2002/12/31/entrez SP - 260-2, table of contents JF - Anesthesia and analgesia JO - Anesth Analg VL - 96 IS - 1 N2 - UNLABELLED: Used as the sole analgesic, clonidine produces analgesia after central neural blockade and intraarticular injection but not after axillary block. In this study, we sought to determine whether interscalene clonidine induces analgesia for shoulder arthroscopy. Forty patients scheduled for shoulder arthroscopy were prospectively included in this double-blinded study. Using a nerve stimulator technique, an interscalene catheter was inserted. The patients were randomly divided into two groups. The interscalene group (n = 20) received clonidine 150 micro g in 15 mL of saline through the catheter and 1 mL of subcutaneous saline, and the systemic group (n = 20) received 15 mL of saline through the catheter and clonidine 150 micro g (1 mL) subcutaneously. All patients underwent general anesthesia for surgery. On completion of arthroscopy, all patients received, via a patient-controlled analgesia, on demand a bolus of 8 mL of ropivacaine 0.2% through the catheter with a 1-h lockout period. Postoperative pain was measured every 4 h using the visual analog scale (VAS) for 24 h. Additional postoperative analgesia was available with parenteral nalbuphine if required until VAS < 3. VAS scores in the recovery room were significantly higher in the systemic group compared with the interscalene group (P < 0.0001). Analgesic duration was significantly longer in the interscalene group (P < 0.00001), and ropivacaine consumption was significantly less than in the systemic group (P < 0.0001). No significant difference was observed between groups for nalbuphine consumption. Side effects were comparable in the two groups. IMPLICATIONS: Clonidine administered via an interscalene catheter enhanced analgesia compared with systemic administration. Nevertheless, the adverse effect of clonidine at this dose limits its use for routine management for postoperative analgesia. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/12505963/The_analgesic_effect_of_interscalene_block_using_clonidine_as_an_analgesic_for_shoulder_arthroscopy_ DB - PRIME DP - Unbound Medicine ER -