Association of clonidine and ropivacaine in brachial plexus block for shoulder arthroscopy

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• 作者：Raphael Faria-Silva ; ^{dr.raphael.faria@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Daniel Câ ; mara de Rezende ; Juarez Mundim Ribeiro ; Telmo Heleno Gomes ; Braulio Antô ; nio Maciel Faria Mota Oliveira ; Fá ; bio Maciel R. Pereira ; Ildeu Afonso de Almeida Filho ; Antô ; nio Ené ; as Rangel de Carvalho Junior
• 关键词：Local anesthetics ; Clonidine ; Arthroscopy ; Postoperative pain
• 刊名：Brazilian Journal of Anesthesiology (English Edition)
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：66
• 期：4
• 页码：335-340
• 全文大小：510 K

文摘

Arthroscopy for shoulder disorders is associated with severe and difficult to control pain, postoperatively. The addition of clonidine to local anesthetics for peripheral nerve block has become increasingly common, thanks to the potential ability of this drug to reduce the mass of local anesthetic required and to prolonging analgesia postoperatively. The present study aimed to evaluate the success of brachial plexus block for arthroscopic rotator cuff surgery using local anesthetic with or without clonidine.

Method

53 patients of both genders, between 18 and 70 years old, American Society of Anesthesiologists I or II, who were scheduled to undergo arthroscopic shoulder surgery were selected. Patients were then randomized into two groups. The verbal numerical pain scale and the presence of motor block were obtained in the post-anesthetic recovery room and 6, 12, 18 and 24 h postoperatively.

Results

The association of clonidine (0.15 mg) to a solution of 0.33% ropivacaine (30 mL) in brachial plexus block for shoulder arthroscopy has not diminished the visual numeric pain scale values, nor the need for opioid rescue postoperatively. There was a lower incidence of nausea/vomiting postoperatively and a significant motor block time prolongation in the group of patients who received clonidine as adjuvant.

Conclusions

The use of brachial plexus block with local anesthetic for analgesic postoperative control is well established in the literature. The addition of clonidine in the dose proposed for prolongation of the analgesic effect and reduction of opioid rescue proved unhelpful.