S A Jeffs1, J E Hall, S Morris. 1. University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK.
Abstract
BACKGROUND:Clonidine is an alpha 2 adrenergic agonist with analgesic properties. This study aimed to see if the addition of clonidine to morphine when given by patient-controlled analgesia (PCA) would improve analgesia beyond the first 12 h after surgery. METHODS:Sixty patients undergoing lower abdominal surgery were recruited into a randomized double blind study. At the end of surgery Group C received an infusion of clonidine 4 micrograms kg-1 over 20 min, PCA clonidine 20 micrograms and morphine 1 mg bolus. Group M received an infusion of saline and then PCA morphine 1 mg bolus. Pain, sedation and nausea and vomiting were assessed after 12, 24 and 36 h, and satisfaction with analgesia was assessed at 36 h. RESULTS:Pain scores were significantly lower in Group C between 0 and 12 h, but thereafter there was no difference. Morphine consumption was the same for both groups until 24-36 h. Nausea and vomiting was significantly reduced in Group C between 0 and 24 h. Patients in Group C were significantly happier with their pain relief (four-point scale).
RCT Entities:
BACKGROUND:Clonidine is an alpha 2 adrenergic agonist with analgesic properties. This study aimed to see if the addition of clonidine to morphine when given by patient-controlled analgesia (PCA) would improve analgesia beyond the first 12 h after surgery. METHODS: Sixty patients undergoing lower abdominal surgery were recruited into a randomized double blind study. At the end of surgery Group C received an infusion of clonidine 4 micrograms kg-1 over 20 min, PCA clonidine 20 micrograms and morphine 1 mg bolus. Group M received an infusion of saline and then PCA morphine 1 mg bolus. Pain, sedation and nausea and vomiting were assessed after 12, 24 and 36 h, and satisfaction with analgesia was assessed at 36 h. RESULTS:Pain scores were significantly lower in Group C between 0 and 12 h, but thereafter there was no difference. Morphine consumption was the same for both groups until 24-36 h. Nausea and vomiting was significantly reduced in Group C between 0 and 24 h. Patients in Group C were significantly happier with their pain relief (four-point scale).
Authors: Michael E Cloesmeijer; Huub L A van den Oever; Ron A A Mathôt; Marieke Zeeman; Arriette Kruisdijk-Gerritsen; Carmen M A Bles; Polina Nassikovker; Arthur R de Meijer; Fred L van Steveninck; Maurits E L Arbouw Journal: Br J Clin Pharmacol Date: 2020-03-29 Impact factor: 4.335