Abstract
Using a randomized blind cross-over design, the comparative efficacy of clonidine in prolonging tetracaine spinal anaesthesia was studied in six mongrel dogs.
Lumbar subarachnoid injections (1 ml) of: tetracaine 4 mg with clonidine 150 µg, tetracaine 4 mg with epinephrine 200 µg, tetracaine 4 mg, clonidine 150 µg, epinephrine 200 µg, and five per cent dextrose in H2O (vehicle) were administered randomly to each animal at 5–7 day intervals.
Subarachnoid tetracaine produced a motor blockade of 186 ± 58 (mean ± SEM) min. Both clonidine and epinephrine produced a similar prolongation of tetracaine motor blockade, 135 percent(p < 0.01 ) and 116 per cent (p < 0.05) respectively, compared with tetracaine alone. No motor blockade was observed in dogs receiving clonidine, epinephrine or five per cent dextrose in H2O. The addition of clonidine to tetracaine spinal anaesthesia produced a significant increase in duration of sensory blockade, 56 per cent (p<0.01) and 107 per cent (p < 0.01) respectively, when compared to tetracaine with and without epinephrine. Subarachnoid clonidine alone produced a sensory blockade of 76 ± 17minutes, while only one animal receiving subarachnoid epinephrine had a sensory blockade (40 minutes). No neurologic deficits were observed in any of the animals.
The study concludes that during spinal anaesthesia with tetracaine in dogs, clonidine is as effective as epinephrine in prolonging motor blockade, but is more effective in prolonging sensory blockade.
Résumé
Avec une étude à double insu randomisée, l’efficacité comparative de la clonidine dans la prolongation d’une rachi-anesthésie à la tetracaïne a été étudiée avec six chiens bâtards.
Des injections sous-arachnoidiennes lombaires (1 ml) de: tetracaïne 4 mg avec clonidine 150 µg, tetracaïne 4mg avec épinephrine 200 µg, tetracaïne 4mg, clonidine 150 µg, épinéphrine 200 µg, et cinq pour cent dextrose dans l’eau ont été administrées d’une façon randomisée à chaque animal avec un intervalle de cinq à sept jours.
L’administration de tetracaïne sous-arachnoïdienne a produit un bloc-moteur de 186 ± 58 (moyenne ± SEM) min. La clonidine de même que léépinéphrine ont produit une prolongation identique du bloc-moteur à la tetracaïne, 135 pour cent (p < 0.01) et 116 pour cent (p < 0.05) respectivement, comparativement à la tetracaïne seule. Aucun bloc-moteur n’a été observé avec la clonidine seule, l’épinéphrine, ou le cinq pour cent glucose dans l’eau. L’addition de clonidine à la tetracaïne pour une rachi-anesthésie a produit une augmentation significative dans la duree du bloc sensoriel, 56 pour cent (p < 0.01) et 107 pour cent (p < 0.01) respectivement, comparativement à la tetracaïne avec ou sans épinéphrine. L’administration rachidienne de clonidine seule a produit un bloc sensoriel de 76 ± 17 minutes, alors qu’un seul chien ayant requ de l’épinéphrine sous-arachnoïdienne a présenté un bloc sensoriel (40 minutes). Aucun déficit neurologique n’a été observé chez aucun de ces animaux.
Cette étude conclut que chez les chiens devant subir une rachi-anesthésie à la tetracaïne, la clonidine est aussi efficace que l’épinéphrine dans la prolongation du bloc-moteur et serait plus efficace dans la prolongation du bloc sensoriel.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Braun H. Lokal Anesthesie, ed. 1, Leipsig, JA Barth, 1905. Braun H. Local Anesthesia, ed. 3 (translated by P. shields), p. 143, Philadelphia, 1914, Lea and Febiger.
Bier A, Donitz A. Ruckenmarksanasthesie, Munchen med. Wehnschr 1904; 1: 593–6.
Heinke H, Lawen A. Experimentelle Untersuchungen und Klinische Erfahrungen uber die verwertbarkeit von Novokain fur die Artliche Anasthesie, Deutsche Zschr. f. Chir. 1905; 80: 180–98.
Bonica JJ, Backup PH, Pratt WH. The use of vasoconstrictors to prolong spinal anaesthesia. Anesthesiology 1951; 12:431–41.
Moore DC, Bridenbaugh LD. Spinal (subarachnoid) block. JAMA 1966; 195: 123–8.
Feldman HS, Covino BG. Effect of vasoconstrictor agents on prolonging the duration of spinal anaesthesia in the dog. Regional Anesthesia 1985; 10: 133–8.
Kozody R, Palahniuk RJ, Wade JG, Gumming MO, Pucci WR. The effect of subarachnoid epinephrine and phenylephrine on spinal cord blood flow. Can AnesthSoc J 1984; 31: 503–8.
Kozody R, Palahniuk RJ, Cumming MO. Spinal cord blood flow following subarachnoid tetracaine. Can Anesth Soc J 1985; 32: 23–9.
Chambers WA, Littlewood DG, Logan MR, Scott DB. Effect of added epinephrine on spinal anesthesia with lidocaine. Anesth Analg 1981; 60: 417–20.
Chambers WA, Littlewood DG, Scott DB. Spinal anesthesia with hyperberic bupivacaine effect of added vasoconstrictors. Anesth Analg 1982; 61: 49–52.
Reddy SV, Ladervt L, Yaksh TL. Spinal cord pharmacology of adrenergic agonist-mediated antinociception. J Pharmacol Exp Ther 1980; 213: 525–33.
Reddy SYR, Yaksh TL. Spinal noradrenergic terminal system mediating antinociception. Brain Research 1980; 189:391–401.
Coombs DW, Sounders RL, Lachance D, Savage S, Ragnarsson TS, Jensen LE. Intrathecal morphine tolerance: use of intrathecal clonidine, DADLE, and intraventricular morphine. Anesthesiology 1985; 62: 358–63.
Weiner N. Drugs that inhibit adrenergic nerves and block adrenergic receptors in The Pharmacological Basis of Therapeutics. Ed. Gilman AC, Goodman LS, Gilman A, New York. MacMillan Pub Co Inc 1980; Chp. 8: 197–8.
Eger EI II,Saidman W, Brandstater B. Minimum alveolar anesthetic concentration: a standard of anesthetic potency. Anes. 1965; 26: 756–63.
Luttinger D, Ferrari R, Perrone MH, Haubrich DR. Pharmacological analysis of alpha-2 adrenergic mechanisms in nociception and ataxia. J Pharmacol Exp Ther 1985; 232: 883–9.
Zemlan FP, Corrigan SA, Pfqff DW. Noradrenergic and serotonergic mediation of spinal analgesia mechanisms. Eur J Pharmacol 1980; 61: 111–24.
Fleetwood-Walker SM, Mitchell R, Hope RJ, Molony V, Iggo A. An alpha2 receptor mediates the selective inhibition by noradrenaline of nociceptive responses of identified dorsal hom neurons. Brain Research 1985; 334: 243–56.
Unnerstall JR, Kopajtic TA, Kihar MJ. Distribution of a2 agonist binding sites in the rat and human central nervous system: analysis of some functional, anatomic correlates of the pharmacologic effects of clonidine and related adrenergic agents. Brain Research Review 1984; 7: 69–101.
Calvillo O, Ghignone M. Primary afferent depolarization of cutaneous C fibers in the cat spinal cord evoked by clonidine. Fed Proc 1985; 2799: 44.
Marwaha J, Kehne JH, Commissaris RL, Lakoski J, Shaw W, Davis M. Spinal clonidine inhibits neural firing in locus coeruleus. Brain Research 1983; 276: 379–82.
Kiowski W, Hulthen UL, Ritz R,Buhler FR. Alpha2 adrenoreceptor mediated vasoconstriction of arteries. Clin Pharmacol Ther 1983; 34: 565–9.
Yaksh TL, Reddy SVR. Studies in the primate on the analgetic effects associated with intrathecal actions of opiates, alpha adrenergic agonists and baclofen. Anesthesiology 1981; 54: 451–67.
Collins JG, Kitahata LM, Matsumoto M, Homma E, Suzukawa M. Spinally administered epinephrine suppresses noxiously evoked activity of WDR neurons in the dorsal horn of the spinal cord. Anesthesiology 1984; 60: 269–75.
Coombs DW, Allen C, Meier FA, Fratkin J. Chronic intraspinal clonidine in the sheep. Regional Anesth 1984; 9: 47 (abstract).
Tamsen A, Gordh TE. Clonidine is not neurotoxic. Lancet, 1984; 2: 876.
Naftchi EN. Functional restoration of the traumatically injured spinal cord in cats by clonidine. Science 1982; 217: 1042–4.
Ghignone M, Quintin L, Duke PC, Kehler CH, Calvillo O. Effects of clonidine on narcotic require ments and hemodynamic response during induction of fentanyl anesthesia and endotracheal intubation. Anesthesiology 1986; 64: 36–42.
Author information
Authors and Affiliations
Additional information
Supported by a grant from the University of Manitoba Faculty Fund.
Rights and permissions
About this article
Cite this article
Bedder, M.D., Kozody, R., Palahniuk, R.J. et al. Clonidine prolongs canine tetracaine spinal anaesthesia. Can Anaesth Soc J 33, 591–596 (1986). https://doi.org/10.1007/BF03014266
Issue Date:
DOI: https://doi.org/10.1007/BF03014266