Low-dose clonidine and neostigmine prolong the duration of intrathecal bupivacaine-fentanyl for labor analgesia

Intrathecal (IT) opioid and local anesthetic combinations are popular for labor analgesia because of rapid, effective pain relief, but the duration of analgesia is limited. This study was undertaken to determine whether the addition of clonidine and neostigmine to IT bupivacaine-fentanyl would incre...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 2000-02, Vol.92 (2), p.361-366
Main Authors: OWEN, M. D, ÖZSARAC, Ö, SAHIN, S, UCKUNKAYA, N, KAPLAN, N, MAGUNACI, I
Format: Article
Language:English
Subjects:
Adjuvants, Anesthesia - administration & dosage
Adjuvants, Anesthesia - adverse effects
Adrenergic alpha-Agonists - administration & dosage
Adrenergic alpha-Agonists - adverse effects
Adult
Analgesia, Obstetrical
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthetics, Local - administration & dosage
Anesthetics, Local - adverse effects
Apgar Score
Biological and medical sciences
Bupivacaine - administration & dosage
Bupivacaine - adverse effects
Cholinesterase Inhibitors - administration & dosage
Cholinesterase Inhibitors - adverse effects
Clonidine - administration & dosage
Clonidine - adverse effects
Female
Fentanyl - administration & dosage
Fentanyl - adverse effects
Humans
Infant, Newborn
Injections, Spinal
Local anesthesia. Pain (treatment)
Medical sciences
Neostigmine - administration & dosage
Neostigmine - adverse effects
Pain Measurement - drug effects
Patient Satisfaction
Pregnancy
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Summary:Intrathecal (IT) opioid and local anesthetic combinations are popular for labor analgesia because of rapid, effective pain relief, but the duration of analgesia is limited. This study was undertaken to determine whether the addition of clonidine and neostigmine to IT bupivacaine-fentanyl would increase the duration of analgesia without increasing side effects for patients in labor. Forty-five healthy parturients in active labor were randomized to receive a 2-ml IT dose of one of the following dextrose-containing solutions using the combined spinal-epidural technique: (1) bupivacaine 2.5 mg and fentanyl 25 microg (BF); (2) BF plus clonidine 30 microg (BFC); or (3) BFC plus neostigmine 10 microg (BFCN). Pain, sensory levels, motor block, side effects, maternal vital signs, and fetal heart rate were systematically assessed. Patients administered BFCN had significantly longer analgesia (165+/-32 min) than those who received BF (90+/-21 min; P
ISSN:0003-3022
1528-1175
DOI:10.1097/00000542-200002000-00016