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Effects of Clonidine Preemptive Analgesia on Acute Postoperative Pain in Abdominal Surgery

Jasminka Peršec
Zoran Peršec
Damir Buković
Ino Husedžinović
Nevia Buković
Ljubomir Pavelić

Puni tekst: engleski pdf 61 Kb

str. 1071-1075

preuzimanja: 477



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 a2-adrenergic agonist clonidine before the onset of pain stimulus resulted in reduced
pain levels, sedation and analgesic requirement.

Ključne riječi

epidural analgesia; patient-controlled analgesia; postoperative pain; pain measurement; clonidine

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