Der Anaesthesist
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Randomized Controlled Trial Clinical Trial
[Does intrathecal clonidine prolong the effect of spinal anesthesia with hyperbaric mepivacaine? A randomized double-blind study].
Clonidine, an alpha 2-receptor agonist, has been reported to prolong the blocking actions of local anaesthetics. The aim of this study was to investigate the effects of spinally injected clonidine on the duration of spinal anaesthesia by mepivacaine and on the postoperative demand for analgesics. ⋯ While clonidine prolonged sensory analgesia, there was also an undesirable prolongation of motor block postoperatively. In addition, there was a significant and long lasting reduction in heart rate and mean arterial pressure in both clonidine groups. Unfavourably, postoperative demand of analgesics was not reduced by spinal injection of clonidine. Thus, the routine addition of clonidine for spinal anaesthesia with local anaesthetics is not recommended.
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Obviously there is a world-wide trend towards regional analgesia for pain relief during delivery. Data on the current practice in Germany are lacking. ⋯ In 1977, 14 of 18 university departments of anaesthesiology offered epidural analgesia for parturients. This option was available in all university departments in 1996. A mean rate of 10-20% epidurals for vaginal delivery is well within the limits reported from other countries, whereas the rate of regional anaesthesia for scheduled caesarean section (40%) still is rather low in Germany, as reported in part 1 of this survey (Anaesthesist 1998;47:59-63).