Clinical study of epidural analgesia with clonidine and sumatriptan in posthysterectomy

Abstract

A clinical study was conducted to compare the analgestic effect of clonidine with those of sumatriptan and their mixture and their effects on hemodynamics. 40 patients undergoing elective total hysterectomy were randomly divided into 4 groups in terms of the epidurally administered drugs with 10 patients in each group (group C₁: clonidine 150 μg, group C₂: clonidine 75 μg, group S: sumatriptan 6 mg and group S+C:clonidine 75 μg + sumatriptan 3 mg). MAP, HR, SpO₂, V_T VAS, VRS and ePDT were measured in the initial 4 h. The demographic data and the doses of intraoperative local anesthetics among the 4 groups were not staistically different. It was found that no significant difference in the pre- and postadministration values of HR, SpO₂ and V_T. A obvious reduction of MAP appeared in the groups of C₁ and C₂, but in the other groups the hemodynamical parameters were stable. The groups of C₁, C₂ and S+C showed significant increase in VAS and VRS, along with increase of ePDT when comapred with the pre-drug level. There was no obvious alteration in group S after the drug administration. It was concluded that (1) single use of sumatriptan is ineffective in the dose given in this study; (2) small dose (150 μg and 75 μg) of clonidine has epidurally analgesic effects; (3) combined use of sumatriptan and clonidine is an acceptable way in epidural analgesia, in terms of its analgesic effect and hemodynamic changes.

Keywords

epidural analgesia / clonidine / sumatriptan

References

[1] WangJ K. Antinociceptive effect of intrathecally administered serotonin. Anesthesiology, 1977, 47: 269-269

[2] Paul Crisp. Drugs: Focus on Sumatriptan. New Zealand, Aids International Ltd. 1992, 43:776

[3] Parren M J. The selective closure of feline carotidartherovenous anastomoses (AVAs) by GR43157. Cephalagia, 1989,(Suppl 9):41

[4] EisenachJ C. Epidural clonidine analgesia following surgury: Phase 1. Anesthesiology, 1989, 71: 640-640

[5] BoicoO, BennetF, RostaingS. Epidural clonidine porduces postoperative analgesia. Indian J Med Res, 1986, 83: 55-55

[6] KaliaP K, MadanR, BatraR K, et al. . Clinical study on epidural clonidine for postoperative analgesia. Anesthesiol Med Res, 1986, 83: 55-55

[7] BonsquetP. Alpha adrenergic drugs: Pharmacologic tools for the study of central vascular control. Biochem Pharmacol, 1983, 32: 1459-1459

[8] WashlM. Local chemical, neural and humoral regulation of cerebrovascular resistance vessels. J Cardiovasc Pharmacol, 1985, 7(3): 838-838