engleski

Attenuation of systemic inflammatory stress response after preoperative analgesia with clonidine compared to levobupivacaine-a randomised clinical trial

Background and purpose: Use of analgetics before the pain stimulus (preventive analgesia) obstruct development of neuroplastic changes in central nervous system, and reduces pain. Furthermore, preventive analgesia can block harmful central nervous system response and inflammation as an early consequence of operation as well. Investigation hypothesis is that preoperative central clonidine will reduce systemic inflammatory stress response better than levobupivacaine. Materials and methods:. Patients were allocated to three groups, according to preoperative epidural use of 5 μg/kg clonidine (n=17), 0.25% levobupivacaine (n=12) or saline as control group (n=13). Before operation, 1 h after the beginning, 1 h, 6 h, 12 h and 24 h after the operation following parameters were analyzed: procalcitonin (PCT), interleukine-6 (IL-6), C- reactive protein (CRP) and lactate. Results: There were no significant differences between groups in age, gender, body mass index and operation time. We demonstrated significant reduction in PCT, IL- 6, CRP and lactate levels in preoperative clonidine group, compared to preoperative levobupivacaine group and controle group.Conclusion. These results support importance of clonidine central effect on pain pathways and systemic inflammatory stress response blockade.

clonidine ; levobupivacaine ; preoperative analgesia ; systemic inflammatory stress response ; epidural analgesia

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