hrvatski

Usporedba centralne primjene klonidina i levobupivakaina obzirom na razinu poslijeoperacijske boli i sustavni upalni odgovor organizma

With perioperative pain control it is possible to supervise immune system, release of inflammation mediators, and influence on treatment outcome. Use of analgetics before the pain stimulus (preventive analgesia) obstruct development of neuroplastic changes in central nervous system, and reduces pain. Investigation hypothesis is that preoperative epidural clonidine is more efficient in blockade of pain and systemic inflammatory stress response comparing to levobupivacaine. Patients are allocated to three groups, according to preoperative epidural use of clonidine, levobupivacaine or saline (control group). There were no significant difference between groups in age, gender, body mass and operation time. Before operation, 1 h after the beginning, 1 h, 6 h, 12 h and 24 h after the operation following parameters were analyzed: procalcitonin, interleukine-6, C-reactive protein, glucose, lactate, leukocyte, lymphocyte, neutrophyl, postoperative pain level, blood pressure, heart rate and analgesics use. We demonstrated significant difference that support importance of clonidine central effect on pain pathways and systemic inflammatory blockade. It is demonstrated, for the first time that preoperative clonidine use will attenuate postoperative pain and systemic inflammatory stress response better than preoperative levobupivacaine. With high statistical objectivity, we can recommend this method in standard clinical practice.

klonidin; levobupivakain; poslijeoperacijska bol; preventivna analgezija

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