Clonidina epidural como analgésico luego de operación cesárea.
Resumen
En un estudio a doble ciego, aleatorio, se compara el efecto analgésico de la clonidina con el fentanil por via epidural en dos grupos de 30 pacientes sometidas a cesarea electiva. El grupo I recibiö 300 ug de clonidina y el grupo Il 100 ug de fentanil. Mediante la escala anåloga visual se midiö la analgesia a los 5, 10, 20 y 30 min; cada hora hasta las 6 h y un control final a las 24 h. La analgesia con clonidina se inici6 a los 13.33 min y se mantuvo hasta las 4.3*0.82 h cuando la analgesia con fentanil comenzö a declinar (P<0.05). Los cambios hemodinåmicos en ambos gupos no fueron significativos. Las reacciones secundarias fueron: hipotensi6n (p<O.02) en el grupo I y prurito (p<0.001) en el grupo Il.
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1 Brodsky, JB. Caudal epidural morphine for post-thoracotomy pain. Anesthesia & Anal1988; 67:409410.
2. Neil A, terenius L Receptor mechanisms for nociception. In Sjostrand UH, Rawal N. Eds Regional Opioids in Anesthesiology and Pain Management. Boston, Little Brown, 1986; p.2.
3. Carabine UA, Milligan KR, Mulholland d, Noore J. Extradural clonidine infusions for analgesia after total hip replacement. British Joumal of Anaesthesia, 1991; 68:338-343.
4. Eisenach JC, Castro MI, Dewan D, Rose JC. Epidural clonidine analgesia in obstetrics: sheep studies. Anesthesiology, 1989 70:51-56.
5 Bonet F, Boico o, Roun S, Saa& M, Loriferne JF, Touboul C, Abhay K, GHgrw ne M. Postoperative analgesia with ral clonidine. British Journal of Anesthesia, 1989; 63:456-469
6. Davies DS, Wing Reid Jl., Nail E, Tippet G. Pharmacokinetics and comartration-effect relationships of intravenous and oral clonidine. Clinical PharmacoG and Therapeutics 1979; 211593-601.
7. Reid JL. The clinical pharmacoloy of clonidine and related central agents. British Journal of Clinical logy, 1981; 12:206-302.
8 Carabine UA, Wrigth PMC, Moore J. Preanesthetic Medication with clonidiæ: a doeresponse study. British Journal of Anaes1991; 67:79-93.
9 Maze M, Segal I, Bloor BC. Clonidine and other alpha-2-adrenergic agonists: Ärüegies for the rational use of these novel agents Journal od Clinical Anaesthesia, 1988; 1:146-157.
10 Flacke JW, Bioor BC, Flacke WE. Reduced narcotic requeriments by proved hemodinamics and adrenergic ty in patients undergoing coronary bypass surgery. Anesthesiology, 1987; 67:11-19
11. Wright PMC, Carabine UN McChme DA, Moore J. Preanaesthetic medication with clonidine. British Journal of 1990; 65:628-632.
12. Bellaiche S. et.al. Clonidine does not delay recovery from anaesthesia. British Journal of Anesthesia, 1991; 66:353-357.
13. Byron C, Bloor PhD. Clonidine and other agonist and important new drug class for the perioperative pa-iod. Seminars in Anaesthesia, 1988; 177
14. Dollery CT et.al. Clinical pharmacology md pharmacokinetics of clonidine(21inical Pharmacology and Therapeutics, 1976; 19:11-17.
15. Huntoon MA, Eisenach JC, Boese P. Epidural clonidine following cesarean sætion: effect of prior local anesthetic. Anesthesiology, 1992;
16 Jean P, Racie MD, AbdllatifB *Prolongation of isobaric bupivacaine spinal an—thesia with epinephrine and clonidine for hip surgery in the elderly. Anesthesia & Analgesia, 1987; 66:442-446.
17 Bloor BC, Flacke WE. Reduction in halothane anesthetic requeriments by clonidine and alpha adrenergic agonist. Anesthesia & 1982; 61:741-745.
18. Boico O, Bonnet F. Epidural clonidine produces postoperative analgesia. Anesthesiology, 1989; 69:3Æ
19. Anders et.al. Epidural clonidine produces analgesia. The Lancet, 1984; 28:231-232.
20. Houston C. Clonidine hidrochloride. Review of pharrnacology and clinical aspects. Progress in Cardiovascular Diseases, 1981, 23:5.
21. Bonnet F, Brun V. Dose-related prologation of hiperbaric tetracarne spinal anesthesia by clonidine in humans. Anesthesia & Analge1989; 68:619-622.
22 Bonnet F, Boico O, Rostaing S, Loriferne JF, Saada M. Clonidine-induced analgesia in postoperative patients. epidural vs intramuscular administration. Anesthesiology, 1990, 72:423-427
23. Lund C, Qvitzau S, Graulich A, ffjortso NC, Kehlet H. Comparison of the effects of extradural clonidine with those of morphine on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block. British Journal of Anaesthesia, 1989; 6±516-519.
24 Mendez R, Eisenach JC, Castan K. Epidural clonidine analgesia following cesarean section. ASA Abstracts, 1990.
25. Bonnet F et al. Effects of oral and subarachnoid clonidine on spinal anesthesia with bupicacaine. Regional Anesthesia, 1990; 15:211-214.
26. Mensink FJ, Kosody R, Kehla CH. Wade JC. Dose-response relationship of clonidine in tetracaine spinal anesthesia. Anesthesiology, 1987; 67•.717-721.
27. Spaulding TC, Fielding S, Venafro JJ, Lac Antinociceptive activity of clonidine and its potentiation of morphine analgesia. European Journal Pharmacology, 1979; 58: 1925.
28 Ghignone M, Cavillo O, Quintin L. Anesthesia and hypertension. The effect of clonidine on perioperative hemodynamcs and isoflurane requeriments. Anesthesiology, 1987, 67:3-10
29. Racle JP, Poy Y, Benkhadra A, et.al. Prolonging hiperbaric bupivacaine spinal anaesthesia with adrenaline and clonidine in the elderly. Annalles Francois Anesthesiology Reanimatiom 1988; 7:139-144
30. Silva LA, De La Paz JL. Efectos analgésicos de la clonidina administrada en el espac10 peridural. Revista Mexicana de Anestesio1991;
31 Petit J, Oksenhendler G, et.al. Pharmacokinetics and effects of epidural clonidine in acute postoperative pain. Reg Anesth, 1989;
32. Rostaing S, Bonnet F, Levron JC, Vodinh J, Pluskwa F, Saada M. Effect of epidural clonidine on analgesia and pharmacokinetics of epidural on postoperative patients. Anesthesiology, 1991;
33 Reisner LS. Anestesia Obstétrica. Prevenciön y alivio del dolor después de cesårea. Clinicas de Anestesiologia de Norteamérica, 1990; 1:155-170.
34 Pitkin RM et.al. Anelgesia epidural y raqwdea con narcöticos. Clinicas Obstétricas y Ginecolögicas, 1987; 3:521-532.
35 Premuda L. Historical perspective in opioid analgesia. Satellite Symposium of the 5th World Congress on Paim 1987:26-28.
36 Donovan M, Dillon P, McGuire L. Incidence and characteristic of pain in a sample of medical surgical in patients. Pain, 1987, 30:69-78.
37 Donovan BD. Patient attitudes to postoperative pain relief. Anesthesiology Intensive care, 1983; 11:125-129.
38 Eisenach JC, Grice SC, Dewan DM. Patient-controlled analgesia following cesarean section: a comparisson with epidural and intramuscular narcotics. Anesthesiology, 1988; 68:444-448
39 Harrison DM, Sinatra R, Morgece L, et.al Epidural narcotic and patient-controlled analgesia for post-cesarean pain relief. Anesthesiology, 1988; 68:454-457.
40 Cohen SE, Woods WA The role of epidural morphine in the post-cesarean patient: effcacy and effects on bonding Anesthesiology, 1983; 58:500-504.
41 Rosen MA, Hughes SC, Schneider SM, et.al. Epidural morphine for relief of postoperative pain after cesarean delivery. Anesthesia & Analgesia, 1983; 62•.666-672.
42 Naulty JS, Datta S, Ostheimer GW, et al Epidural fentanil for post-cesarean delivery pain management. Anesthesiology, 1985, 63:694-698.
43 Cousins Nfl, Mather LE. Intrathecal and administration administration of opioids. Anesthesiology, 1984; 61:276-310.
2. Neil A, terenius L Receptor mechanisms for nociception. In Sjostrand UH, Rawal N. Eds Regional Opioids in Anesthesiology and Pain Management. Boston, Little Brown, 1986; p.2.
3. Carabine UA, Milligan KR, Mulholland d, Noore J. Extradural clonidine infusions for analgesia after total hip replacement. British Joumal of Anaesthesia, 1991; 68:338-343.
4. Eisenach JC, Castro MI, Dewan D, Rose JC. Epidural clonidine analgesia in obstetrics: sheep studies. Anesthesiology, 1989 70:51-56.
5 Bonet F, Boico o, Roun S, Saa& M, Loriferne JF, Touboul C, Abhay K, GHgrw ne M. Postoperative analgesia with ral clonidine. British Journal of Anesthesia, 1989; 63:456-469
6. Davies DS, Wing Reid Jl., Nail E, Tippet G. Pharmacokinetics and comartration-effect relationships of intravenous and oral clonidine. Clinical PharmacoG and Therapeutics 1979; 211593-601.
7. Reid JL. The clinical pharmacoloy of clonidine and related central agents. British Journal of Clinical logy, 1981; 12:206-302.
8 Carabine UA, Wrigth PMC, Moore J. Preanesthetic Medication with clonidiæ: a doeresponse study. British Journal of Anaes1991; 67:79-93.
9 Maze M, Segal I, Bloor BC. Clonidine and other alpha-2-adrenergic agonists: Ärüegies for the rational use of these novel agents Journal od Clinical Anaesthesia, 1988; 1:146-157.
10 Flacke JW, Bioor BC, Flacke WE. Reduced narcotic requeriments by proved hemodinamics and adrenergic ty in patients undergoing coronary bypass surgery. Anesthesiology, 1987; 67:11-19
11. Wright PMC, Carabine UN McChme DA, Moore J. Preanaesthetic medication with clonidine. British Journal of 1990; 65:628-632.
12. Bellaiche S. et.al. Clonidine does not delay recovery from anaesthesia. British Journal of Anesthesia, 1991; 66:353-357.
13. Byron C, Bloor PhD. Clonidine and other agonist and important new drug class for the perioperative pa-iod. Seminars in Anaesthesia, 1988; 177
14. Dollery CT et.al. Clinical pharmacology md pharmacokinetics of clonidine(21inical Pharmacology and Therapeutics, 1976; 19:11-17.
15. Huntoon MA, Eisenach JC, Boese P. Epidural clonidine following cesarean sætion: effect of prior local anesthetic. Anesthesiology, 1992;
16 Jean P, Racie MD, AbdllatifB *Prolongation of isobaric bupivacaine spinal an—thesia with epinephrine and clonidine for hip surgery in the elderly. Anesthesia & Analgesia, 1987; 66:442-446.
17 Bloor BC, Flacke WE. Reduction in halothane anesthetic requeriments by clonidine and alpha adrenergic agonist. Anesthesia & 1982; 61:741-745.
18. Boico O, Bonnet F. Epidural clonidine produces postoperative analgesia. Anesthesiology, 1989; 69:3Æ
19. Anders et.al. Epidural clonidine produces analgesia. The Lancet, 1984; 28:231-232.
20. Houston C. Clonidine hidrochloride. Review of pharrnacology and clinical aspects. Progress in Cardiovascular Diseases, 1981, 23:5.
21. Bonnet F, Brun V. Dose-related prologation of hiperbaric tetracarne spinal anesthesia by clonidine in humans. Anesthesia & Analge1989; 68:619-622.
22 Bonnet F, Boico O, Rostaing S, Loriferne JF, Saada M. Clonidine-induced analgesia in postoperative patients. epidural vs intramuscular administration. Anesthesiology, 1990, 72:423-427
23. Lund C, Qvitzau S, Graulich A, ffjortso NC, Kehlet H. Comparison of the effects of extradural clonidine with those of morphine on postoperative pain, stress responses, cardiopulmonary function and motor and sensory block. British Journal of Anaesthesia, 1989; 6±516-519.
24 Mendez R, Eisenach JC, Castan K. Epidural clonidine analgesia following cesarean section. ASA Abstracts, 1990.
25. Bonnet F et al. Effects of oral and subarachnoid clonidine on spinal anesthesia with bupicacaine. Regional Anesthesia, 1990; 15:211-214.
26. Mensink FJ, Kosody R, Kehla CH. Wade JC. Dose-response relationship of clonidine in tetracaine spinal anesthesia. Anesthesiology, 1987; 67•.717-721.
27. Spaulding TC, Fielding S, Venafro JJ, Lac Antinociceptive activity of clonidine and its potentiation of morphine analgesia. European Journal Pharmacology, 1979; 58: 1925.
28 Ghignone M, Cavillo O, Quintin L. Anesthesia and hypertension. The effect of clonidine on perioperative hemodynamcs and isoflurane requeriments. Anesthesiology, 1987, 67:3-10
29. Racle JP, Poy Y, Benkhadra A, et.al. Prolonging hiperbaric bupivacaine spinal anaesthesia with adrenaline and clonidine in the elderly. Annalles Francois Anesthesiology Reanimatiom 1988; 7:139-144
30. Silva LA, De La Paz JL. Efectos analgésicos de la clonidina administrada en el espac10 peridural. Revista Mexicana de Anestesio1991;
31 Petit J, Oksenhendler G, et.al. Pharmacokinetics and effects of epidural clonidine in acute postoperative pain. Reg Anesth, 1989;
32. Rostaing S, Bonnet F, Levron JC, Vodinh J, Pluskwa F, Saada M. Effect of epidural clonidine on analgesia and pharmacokinetics of epidural on postoperative patients. Anesthesiology, 1991;
33 Reisner LS. Anestesia Obstétrica. Prevenciön y alivio del dolor después de cesårea. Clinicas de Anestesiologia de Norteamérica, 1990; 1:155-170.
34 Pitkin RM et.al. Anelgesia epidural y raqwdea con narcöticos. Clinicas Obstétricas y Ginecolögicas, 1987; 3:521-532.
35 Premuda L. Historical perspective in opioid analgesia. Satellite Symposium of the 5th World Congress on Paim 1987:26-28.
36 Donovan M, Dillon P, McGuire L. Incidence and characteristic of pain in a sample of medical surgical in patients. Pain, 1987, 30:69-78.
37 Donovan BD. Patient attitudes to postoperative pain relief. Anesthesiology Intensive care, 1983; 11:125-129.
38 Eisenach JC, Grice SC, Dewan DM. Patient-controlled analgesia following cesarean section: a comparisson with epidural and intramuscular narcotics. Anesthesiology, 1988; 68:444-448
39 Harrison DM, Sinatra R, Morgece L, et.al Epidural narcotic and patient-controlled analgesia for post-cesarean pain relief. Anesthesiology, 1988; 68:454-457.
40 Cohen SE, Woods WA The role of epidural morphine in the post-cesarean patient: effcacy and effects on bonding Anesthesiology, 1983; 58:500-504.
41 Rosen MA, Hughes SC, Schneider SM, et.al. Epidural morphine for relief of postoperative pain after cesarean delivery. Anesthesia & Analgesia, 1983; 62•.666-672.
42 Naulty JS, Datta S, Ostheimer GW, et al Epidural fentanil for post-cesarean delivery pain management. Anesthesiology, 1985, 63:694-698.
43 Cousins Nfl, Mather LE. Intrathecal and administration administration of opioids. Anesthesiology, 1984; 61:276-310.
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Publicado
2017-06-26
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1.
Pareja M, Quezada L, Vallejo A. Clonidina epidural como analgésico luego de operación cesárea. Rev Fac Cien Med (Quito) [Internet]. 26 de junio de 2017 [citado 30 de abril de 2024];20(3-4):10-7. Disponible en: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/807
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