Anesthesia (18)

Small‐dose clonidine prolongs postoperative analgesia after sciatic‐femoral nerve block with 0.75% ropivacaine for foot surgery. (University of Milan, Milan, Italy) Anesth Analg 2000;91:388–392. This study evaluated the effects of adding small‐dose clonidine to 0.75% ropivacaine during peripheral nerve blocks, 30 ASA physical status I and II patients undergoing hallux valgus repair under combined sciatic‐femoral nerve block were randomly allocated in a double‐blinded fashion to receive block placement with 30 mL of either 0.75% ropivacaine alone (Group Ropivacaine, n = 15) or 0.75% ropivacaine plus μg/kg clonidine (Group Ropivacaine‐Clonidine, n = 15). Hemodynamic variables, oxygen saturation, and levels of sedation, as well as the time required to achieve surgical block and time to first analgesic request, were recorded by a blinded observer. Time to surgical blockade required 10 min in both groups. Patients in the Ropivacaine‐Clonidine Group were more sedated than patients in the Ropivacaine Group only 10 min after block placement. No differences in oxygen saturation and hemodynamic variables, degree of pain measurement at first analgesic request, and consumption of postoperative analgesics were observed between the two groups. The mean time from block placement to first request for pain medication was shorter in Group Ropivacaine (13.7 h; 25 th –75 th percentiles: 11.8–14.5 h) than in Group Ropivacaine‐Clonidine (16.8; 25 th –75 th percentiles: 13.5–17.8 h) ( P = 0.038). Conclude that adding 1 μg/kg clonidine to 0.75% ropivacaine provided a 3‐h delay in first request for pain medication after hallus valgus repair, with no clinically relevant side effects.