Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Effects of clonidine preemptive analgesia on acute postoperative pain in abdominal surgery

Peršec, Jasminka and Peršec, Zoran and Buković, Damir and Husedžinović, Ino and Buković, Nevia and Pavelić, Ljubomir (2007) Effects of clonidine preemptive analgesia on acute postoperative pain in abdominal surgery. Collegium antropologicum, 31 (4). pp. 1071-1075. ISSN 0350-6134 (Print)

[img]
Preview
PDF
Download (61Kb) | Preview

    Croatian abstract

    Preemptivna analgezija podrazumijeva blokadu uzlaznih živčanih puteva prije nastanka bolnog podražaja, čime se sprječava ili smanjuje razina nastale boli. Cilj ove studije bila je usporedba učinka klonidina primjenjenog prije operacije i na kraju operacije na smanjenje poslijeoperacijske boli. Ukupno 77 bolesnika predviđenih za operacijski zahvat u kolorektalnoj kirurgiji metodom randomizacije podijeljeno je u tri skupine: epiduralni klonidin prije operacije, epiduralni klonidin na kraju operacije i kontrolna skupina. Nakon operacijskog zahvata, na zahtjev bolesnika primjenjivana je epiduralna analgezija bolusima morfina. Kao mjere ishoda istraživanja, u vremenskom slijedu 1., 2., 6., i 24. sata od operacijskog zahvata proučavani su parametri razine poslijeperacijske boli korištenjem VAS ljestvice (vizualno analogna skala), sedacije i potrošnje analgetika. Klonidin primjenjen prije operacije iskazao je značajno niže vrijednosti boli u 6. i 24. satu ispitivanja (p<0,05). Klonidin primjenjen na kraju operacije imao je niže vrijednosti boli u 1. i 2. satu, s značajnim porastom razine boli nakon tog vremena (6,93±1,66 u 6. satu i 4,04±2,39 u 24. satu) u usporedbi s klonidinom prije operacije (3,60±2,94 i 3,71±1,82). Klonidin prije operacije iskazao je značajno nižu razinu sedacije (p<0,05) i manju potrošnju analgetika (p<0,05). Blokada nocicepcijskog impulsa primjenom centralno djelujućeg a2-adrenergičkog agonista klonidina prije nastanka osjeta boli dovodi do smanjenja razine poslijeoperacijske boli, sedacije i potrebe za analgeticima.

    English abstract

    Preemptive analgesia refers to blockade of afferent nerve fibers before a painful stimulus, which prevents or reduces subsequent pain even beyond the effect of the block. The aim of the study was to compare the effect of clonidine used before and at the end of operation on pain control in abdominal surgery. A total of 77 patients admitted for colorectal surgery were randomly classified into three groups: epidural clonidine before operation, epidural clonidine at the end of operation, and control group. After the operation on patient demand, analgesia with boluses of epidural morphine was instituted. The parameters of postoperative pain level using VAS score (visual analog scale), sedation and analgesics consumption were determined as outcome measures at 1, 2, 6, and 24 h of the operation. Clonidine administered before operation provided lowest pain scores at 6 and 24 h (p < 0.05). Clonidine administered at the end of operation had low pain scores at 1 and 2 h, with a significant pain breakthrough thereafter (6.93 +/- 1.66 at 6 h and 4.04 +/- 2.39 at 24 h) compared with the group administered clonidine before operation (3.60 +/- 2.94 and 3.71 +/- 1.82). Clonidine administered before operation provided less sedation (p < 0.05) and a significantly lower use of analgesics (p < 0.05). Blockade of nociceptive stimulus using the centrally acting alpha2-adrenergic agonist clonidine before the onset of pain stimulus resulted in reduced pain levels, sedation and analgesic requirement.

    Item Type: Article
    MeSH: Adrenergic alpha-Agonists - administration & dosage ; Clonidine - administration & dosage ; Pain, Postoperative - drug therapy ; Abdomen - surgery ; Acute Disease ; Adult ; Aged ; Humans ; Middle Aged
    Divisions: Katedra za ginekologiju i opstetriciju
    Depositing User: Boris Čičovački
    Status: Published
    Creators:
    CreatorsEmail
    Peršec, Jasminka
    Peršec, Zoran
    Buković, Damir
    Husedžinović, Ino
    Buković, Nevia
    Pavelić, Ljubomir
    Date: December 2007
    Date Deposited: 10 Oct 2008
    Last Modified: 23 Sep 2011 18:10
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/435

      Actions (login required)

      View Item

      Document Downloads

      More statistics for this item...