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ABSTRACT: Low-dose hyperbaric bupivacaine has been used to produce unilateral spinal anaesthesia for outpatient surgery. Unilateral spinal anaesthesia is associated with reduction of hypotension, faster recovery and increased patient satisfaction. Small doses of clonidine have shown effectiveness in intensifying spinal anaesthesia. We investigated the effect of adding 15 microg of clonidine to 5 mg hyperbaric bupivacaine on unilaterality.
Sixty patients undergoing outpatient knee arthroscopy were randomly allocated to receive either 1.2 ml (6 mg) of hyperbaric bupivacaine or a 1.2 ml solution containing 1.0 ml (5 mg) hyperbaric bupivacaine, 0.1 ml (75 microg) clonidine and 0.1 ml sterile water. The motor block was assessed by a modified Bromage scale and the sensory block by a pinprick.
There was a significant difference in the spread of anaesthesia between the operated and contralateral sides in both groups. Seventy-seven per cent of the blocks were unilateral in group B and 73% in group B-C. There was no significant difference between the groups, in unilaterality. The motor block was prolonged in group B-C but it did not affect home-readiness. Patients receiving clonidine needed more vasopressors. There was a significant difference in blood pressures between the groups, being lower in group B-C after 1 h 45 min.
Using 5 mg hyperbaric bupivacaine with 15 microg of clonidine, the unilaterality can be achieved and spinal anaesthesia intensified without affecting home-readiness. More vasopressors are needed in the beginning, but after the surgery patients experienced less pain.
Acta Anaesthesiologica Scandinavica 05/2009; 53(6):788-93. · 2.19 Impact Factor
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ABSTRACT: We compared the pharmacokinetics of 10 mg oral oxycodone in four groups of 10 patients each, aged 20-40, 60-70, 70-80, and 80-90 years. Patients aged 70-80 and 80-90 years had 50-80% higher mean exposure to oxycodone (P < 0.05) and a twofold higher plasma oxycodone concentration (P < 0.05) than the young adults 12 h after ingestion of the drug. Because oxycodone pharmacokinetics depend to a great extent on the age of the subject, it is important to titrate the analgesic dose individually, particularly in the elderly.
Clinical Pharmacology & Therapeutics 11/2008; 84(4):462-7. · 6.04 Impact Factor
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ABSTRACT: We compared the pharmacokinetics of 10 mg oral oxycodone in four groups of 10 patients each, aged 20-40, 60-70, 70-80, and 80-90 years. Patients aged 70-80 and 80-90 years had 50-80% higher mean exposure to oxycodone (P < 0.05) and a twofold higher plasma oxycodone concentration (P < 0.05) than the young adults 12 h after ingestion of the drug. Because oxycodone pharmacokinetics depend to a great extent on the age of the subject, it is important to titrate the analgesic dose individually, particularly in the elderly.Clinical Pharmacology & Therapeutics (2008) doi:10.1038/clpt.2008.64.
Clinical Pharmacology & Therapeutics 04/2008; · 6.04 Impact Factor
