Skip to main content

Use of Clonidine as an Adjuvant to Infiltration Anaesthesia in Tympanoplasty: A Randomized Double Blind Study

Indian Journal of Otolaryngology and Head & Neck Surgery volume 66, pages 57–62 (2014)Cite this article

Abstract

This prospective double blind randomized study evaluated the effect of clonidine when used as an adjuvant to local anaesthetic agents for infiltration block and measured its impact on the quality of anaesthesia, intraoperative bleeding and post-operative pain. We recruited 60 patients needing tympanoplasty, which were randomized them into two groups; group A patients received local infiltration of 12 ml 2 % xylocaine with adrenaline (1:200,000 dilution), while group B received 12 ml 2 % xylocaine with adrenaline with 30 μg of clonidine. Duration of block was significantly prolonged in group B (group A 53.66 ± 7.7 vs. group B 177.13 ± 48.9, p < 0.005). Mean pain scores were significantly lower in group B during the first hour following the block (3.43 in group A vs. 1.2 in group B, p < 0.005). Total number of analgesic doses over 24 h showed no significant difference (3.1 in group B vs. 3.26 in group A, p > 0.05). 93.3 % patients in group A required sedation with midazolam, compared to 10 % in group B. Grade of bleeding was significantly lower in group B. Patient and surgeon satisfaction scores were better in group B. It could be concluded that 30 μg clonidine added to lidocaine 2 % has a significant impact in decreasing the bleeding in the operative field and improving the quality of intraoperative anesthesia as well as prolonging the duration of postoperative analgesia without significant side effects.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Mirko T (1993) Manual of middle ear surgery, 1st edn. Thieme, New York, pp 7–10

    Google Scholar 

  2. Basker S, Singh G, Jacob R (2009) Clonidine in paediatrics—a review. Indian J Anaesth 53:270–280

    PubMed Central  PubMed  Google Scholar 

  3. Arora K, Singh S (2011) Effect of oral clonidine premedication on perioperative haemodynamic response and postoperative analgesic requirement for patients undergoing laparoscopic cholecystectomy. Indian J Anaesth 55(1):26–30

    Article  PubMed Central  PubMed  Google Scholar 

  4. Duma A, Urbanek B, Sitzwohl C, Kreiger A, Zimpfer M, Kapral S (2005) Clonidine as an adjuvant to local anaesthetic axillary brachial plexus block: a randomized controlled study. Br J Anaesth 94:112–116

    Article  CAS  PubMed  Google Scholar 

  5. Casati A, Magistris L, Fanelli G, Beccaria P, Cappelleri G, Aldegheri G et al (2000) Small dose clonidine prolongs postoperative analgesia after sciatic-femoral nerve block with 0.75 % ropivacaine for foot surgery. Anesth Analg 91:388–392

    CAS  PubMed  Google Scholar 

  6. Boezaart AP, Vander MJ, Coetzee A (1995) Comparison of sodium nitroprusside and esmolol induced controlled hypotension for functional endoscopic sinus surgery. Can J Anaesth 42:373–376

    Article  CAS  PubMed  Google Scholar 

  7. Nishikawa T, Dohi S (1990) Clinical evaluation of clonidine added to lidocaine solution for epidural anesthesia. Anesthesiology 73:853–859

    Article  CAS  PubMed  Google Scholar 

  8. Singelyn FJ, Dangoisse M, Bartholomee S, Gouverneur JM (1992) Adding clonidine to mepivacaine prolongs the duration of anaesthesia and analgesia after axillary plexus block. Reg Anaesth 17:148–150

    CAS  Google Scholar 

  9. Singelyn FJ, Gouverneur JM, Robert A (1996) A minimum dose of clonidine added to mepivacaine prolongs the duration of anaesthesia and analgesia after axillary brachial plexus block. Anesth Analg 83:1046–1050

    CAS  PubMed  Google Scholar 

  10. Gaumann DM, Brunet PC, Jirounek P (1992) Clonidine enhances the effects of lidocaine on C-fibre action potential. Anesth Analg 74:719–725

    Article  CAS  PubMed  Google Scholar 

  11. Elliot S, Eckersall S, Fligelstone L, Jothilingam S (1997) Does the addition of clonidine affect duration of analgesia of bupivacaine wound infiltration in inguinal hernia surgery? Br J Anaesth 79:446–449

    Article  Google Scholar 

  12. Acalovschi I, Bodolea C, Manoiu C (1997) Spinal anesthesia with meperidine: effects of added alpha-adrenergic agonists—epinephrine versus clonidine. Anesth Analg 84:1333–1339

    CAS  PubMed  Google Scholar 

  13. Pratap JN, Shankar RK, Goroszeniuk T (2007) Co-injection of clonidine prolongs the anesthetic effect of lidocaine skin infiltration by a peripheral action. Anesth Analg 104(4):982–983

    Article  CAS  PubMed  Google Scholar 

  14. Welfringer P, Manel J, Garric J (1992) Clonidine premedication and isoflurane anesthesia to reduce bleeding in otologic surgery. Ann Fr Anesth Reanim 11(2):125–131

    Article  CAS  PubMed  Google Scholar 

  15. Marchal JM, Gomez-Luque A, Martos-Crespo F et al (2001) Clonidine decreases intraoperative bleeding in middle ear microsurgery. Acta Anaesthesiol Scand 45(5):627–633

    Article  CAS  PubMed  Google Scholar 

  16. Taheri A, Javadimaesh MA, Ashraf H (2010) The effect of oral clonidine premedication on nausea and vomiting after ear surgery. Middle East J Anesthesiol 20:691–694

    PubMed  Google Scholar 

  17. Mikawa K, Nishina K, Maekawa N, Asano M, Obara H (1995) Oral clonidine premedication reduces vomiting in children after strabismus surgery. Can J Anaesth 42(11):981–997

    Article  Google Scholar 

  18. Jenkins LC, Lahav D (1971) Central mechanisms of vomiting related to catecholamine response: anaesthetic implication. Can Anaesth Soc J 18:434–441

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interests

None declared.

Author information

Authors and Affiliations

  1. Department of ENT, LN Medical College and JK Hospital, Kolar Road, Bhopal, MP, 462042, India

    Shiv Kumar Raghuwanshi

  2. Department of Anesthesia, LN Medical College, Bhopal, India

    Nupur Chakravarty

  3. Department of Dermatology, AIIMS, Bhopal, India

    Dinesh Prasad Asati

  4. Department of Preventive and Social Medicine, LN Medical College, Bhopal, India

    Vishal Bankwar

Authors
  1. Shiv Kumar Raghuwanshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nupur Chakravarty
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dinesh Prasad Asati
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vishal Bankwar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shiv Kumar Raghuwanshi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Raghuwanshi, S.K., Chakravarty, N., Asati, D.P. et al. Use of Clonidine as an Adjuvant to Infiltration Anaesthesia in Tympanoplasty: A Randomized Double Blind Study. Indian J Otolaryngol Head Neck Surg 66, 57–62 (2014). https://doi.org/10.1007/s12070-013-0664-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-013-0664-4

Keywords

  • Lidocaine 2 % with adrenaline
  • Tympanoplasty
  • Local infiltration
  • Clonidine