CLONIDINE COMBINED WITH SUFENTANIL AND BUPIVACAINE WITH ADRENALINE FOR OBSTETRIC ANALGESIA

Clonidine produces analgesia via a non-opioid mechanism and it may be used as an interesting adjuvant to local anaesthetics and opioids in o bstetric analgesia. To examine the effects of the addition of clonidin e to bolus injections of bupivacaine, adrenaline and sufentanil, we en rolled 50 women receiving extradural analgesia for vaginal delivery in to a double-blind study. They were allocated randomly to two groups: g roup A received a 10-ml extradural solution of bupivacaine 12.5 mg com bined with adrenaline 25 mug and sufentanil 10 mug; group B received t he same solution with clonidine 30 mug. Each patient was allowed two s ubsequent injections of the chosen solution. Subsequently, if still in the first stage of labour, analgesia was augmented with additional 10 -ml injections of bupivacaine 12.5 mg with adrenaline 25 mug, without sufentanil or clonidine. The latter solution was used for perineal ana lgesia in group A; clonidine 30 mug was added in group B. During the f irst and second stages of labour, there was no difference between the two groups in duration of analgesia after the first injection (142 min in group A; 127 min in group B), number of injections (1.8 in group A ; 1.9 in group B) and the total bupivacaine requirements (33.9 mg in g roup A; 34 mg in group B). The quality of analgesia was evaluated as v ery good in both groups. (23/25 in group A; 24/25 in group B). The deg ree of motor block or the frequency of other side effects were not enh anced by clonidine. Analgesia was greater for episiotomy in group B (1 5/20 in group A; 21/21 in group B) (P < 0.05). Within the limits of th is study, the total dose of extradural clonidine 90 mug appeared to be safe for the mother and the child.