• Iheb Labbene, Hedi Gharsallah, Anis Abderrahman, Mondher Belhadj Amor, Walid Trabelsi, Zied Hajjej, and Mustapha Ferjani.
• Hopital Militaire, Tunis, Tunisie.
• Tunis Med. 2011 Nov 1;89(11):853-9.

BackgroundFor the combined spinal epidural analgesia for labour, 30 mcg of subarachnoid clonidine has proved its effectiveness to extend the analgesia, but increased severe hemodynamic effects.AimTo assess the effectiveness and the safety of 15 mcg intra thecal clonidine for labour analgesia.MethodsFour months, prospective, randomised, simple blind Study, including ASA I or II women, with mono foetal pregnancy. Patients were randomised in 2 groups: SB Group received intra thecal isobaric bupivacaine 2.5 mg and sufentanil 5 mcg and SBC Group received 15 mcg clonidine added to the same doses of bupivacaïne and sufentanil. Epidural analgesia was used when VAS is more than 30. Studied parameters were: delay of installation, duration of analgesia, VAS score, hemodynamic parameters and the incidence of maternal and neonatal side effects.ResultsSixty pregnant women were included (27 in SBC Group and 33 in SB group). The duration of initial analgesia was significantly longer in the SBC group (145 ± 43 min) compared with the SB group (98 ± 28 min). The delay of analgesia, sensory level and motor block level were similar. There was neither significant increase of the low incidence of blood pressure nor of the ephedrine consumption. The abnormalities of fetal heart rate, the mode of delivery and the incidence of side effects were also similar.ConclusionThe addition of 15 mcg intra thecal clonidine to the bupivacaine and the sufentanil during combined spinal epidural analgesia for obstetrical labour results in extended significantly duration of analgesia without increasing side effects.

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