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British Journal of Anaesthesia, 2002, Vol. 89, No. 4 562-566
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Epinephrine and clonidine do not improve intrathecal sufentanil analgesia after total hip replacement{dagger}

R. Fournier*, E. Van Gessel, A. Weber and Z. Gamulin

Department of Anaesthesiology, University Hospital of Geneva, CH-1211 Geneva 14, Switzerland*Corresponding author: Département d’Anesthésiologie, Hôpital Cantonal Universitaire, CH-11 Genève 14, Switzerland

{dagger} Presented in part at the Annual Meeting of the American Society of Anesthesiology, San Francisco, October 2000.

Background. We compared analgesia after intrathecal sufentanil alone, sufentanil with epinephrine 200 µg and sufentanil with clonidine 30 µg in patients after total hip replacement, the endpoints being onset and duration of action.

Methods. We performed a randomized double-blind study of 45 patients for elective total hip arthroplasty using continuous spinal anaesthesia. As soon as a pain score higher than 3 on a 10 cm visual analogue scale was reported, sufentanil 7.5 µg alone, sufentanil 7.5 µg + epinephrine 200 µg or sufentanil 7.5 µg + clonidine 30 µg in 2 ml normal saline was given intrathecally. Pain scores, rescue analgesia (diclofenac and morphine) and adverse effects (respiratory depression, postoperative nausea and vomiting, itching) were observed for 24 h after surgery.

Results. Time to a pain score of <3 [6 (SD 1) vs 6 (1) vs 5 (1) min], time to the lowest pain score [7 (2) vs 8 (2) vs 8 (2) min] and time to the first dose of systemic analgesic for a pain score >3 [281 (36) vs 288 (23) vs 305 (30) min] were similar in all three groups. Adverse effects and analgesic requirements during the first 24 h were also similar.

Conclusion. After total hip replacement, all three analgesic regimens gave good analgesia with comparable onset and duration of action, and minor adverse effects.

Br J Anaesth 2002; 89: 562–6


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