• L Delaunay, C Leppert, V Dechaubry, J C Levron, N Liu, and F Bonnet.
• Service d'Anesthésie Réanimation, Hôpital Henri Mondor, Créteil, France.
• Reg Anesth. 1993 May 1;18(3):176-80.

ObjectiveThis study assesses the possibility that clonidine may decrease analgesic opioid demand in postoperative patients.MethodsTwenty-five patients were allocated randomly after abdominal surgery to receive either an epidural bolus dose of fentanyl (1.0 mcg.kg-1) followed by a 1.0 mcg.kg-1h-1 continuous epidural infusion, or an epidural bolus dose of fentanyl (1.0 mcg.kg-1) followed by a continuous epidural infusion combining fentanyl 0.5 mcg.kg-1 x h-1 and clonidine 0.3 mcg.kg-1 x h-1. Pain was assessed at definite intervals on a visual analog scale (VAS) over 3 postoperative days. Epidural infusion was halved when VAS score was lower than 2. Patients were monitored with a pulse oximeter over 12 hours during the first postoperative night. Plasma fentanyl was measured by radioimmunoassay when patients left the recovery room and at 8 a.m. on the first and the second postoperative days.ResultsVAS scores were comparable in the two groups of patients. The amount of fentanyl delivered was significantly lower in the fentanyl + clonidine group, as were the plasma fentanyl concentrations. The duration of SaO2 < 90% episodes was significantly less prolonged in the fentanyl + clonidine group (3.5 +/- 4.8 minutes versus 14.4 +/- 14.6 minutes).ConclusionsThe combination of clonidine to epidural fentanyl allows a decrease in opioid requirements without impairing analgesia. Reduction of opioids administration may have beneficial effects on respiratory function in postoperative patients.

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