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Giangiacomo Torri - One of the best experts on this subject based on the ideXlab platform.
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, G Aldegheri, L Magistris, G Fanelli, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:UNLABELLED To evaluate 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 1 microg/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 measured 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; 25th-75th percentiles: 11. 8-14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th-75th percentiles: 13.5-17.8 h) (P = 0.038). We conclude that adding 1 microg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. IMPLICATIONS This prospective, randomized, double-blinded study demonstrated that, when providing combined sciatic-femoral nerve block for hallux valgus repair, the addition of 1 microg/kg clonidine to 0.75% Ropivacaine prolongs the duration of postoperative analgesia by 3 h, with only a slight and short-lived increase in the degree of sedation and no hemodynamic adverse effects.
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, L Magistris, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:To evaluate 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 5 15) or 0.75% Ropivacaine plus 1 mg/kg clonidine (group RopivacaineClonidine, n 5 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 measured 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; 25th‐75th percentiles: 11.8 ‐14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th‐75th percentiles: 13.5‐17.8 h) (P 5 0.038). We conclude that adding 1 mg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. (Anesth Analg 2000;91:388 ‐92)
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interscalene brachial plexus anaesthesia with 0 5 0 75 or 1 Ropivacaine a double blind comparison with 2 mepivacaine
BJA: British Journal of Anaesthesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Eleonora Colnaghi, Giangiacomo TorriAbstract:We have compared interscalene brachial plexus block performed with Ropivacaine or mepivacaine in 60 healthy patients undergoing elective shoulder surgery. Patients were allocated randomly to receive interscalene brachial plexus anaesthesia with 20 ml of 0.5% Ropivacaine ( n = 15), 0.75% Ropivacaine ( n = 15), 1 % Ropivacaine ( n = 15) or 2% mepivacaine ( n = 15). Readiness for surgery (loss of pinprick sensation from C4 to C7 and inability to elevate the limb from the bed) was achieved sooner with 1% Ropivacaine (mean 10 (sd 5) min) than with 0.5% Ropivacaine (22 (7) min) ( P P P
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pulmonary function changes after interscalene brachial plexus anesthesia with 0 5 and 0 75 Ropivacaine a double blinded comparison with 2 mepivacaine
Anesthesia & Analgesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Giangiacomo TorriAbstract:UNLABELLED: The purpose of this investigation was to compare, in a prospective, double-blinded fashion, 0.5% and 0.75% Ropivacaine with 2% mepivacaine to determine their effects on respiratory function during interscalene brachial plexus (IBP) anesthesia. With ethical committee approval and written, informed consent, 30 healthy patients presenting for elective shoulder capsuloplastic or acromioplastic procedures were randomized to receive IBP anesthesia by 20 mL of either 0.5% Ropivacaine (n = 10), 0.75% Ropivacaine (n = 10), or 2% mepivacaine (n = 10). Block onset time, pulmonary function variables, ipsilateral hemidiaphragmatic motion (ultrasonographic evaluation), and first requirement of postoperative analgesic were evaluated. Surgical anesthesia (loss of pinprick sensation from C4 to C7 and motor block of the shoulder joint) was achieved later with 0.5% Ropivacaine than with either 0.75% Ropivacaine or 2% mepivacaine (P < 0.05), whereas the first pain medication was requested later with both Ropivacaine concentrations than with mepivacaine (P < 0.0005). No differences in quality of the block or patient acceptance were observed in the three groups. All 30 patients had ipsilateral hemidiaphragmatic paresis and large mean decreases in forced vital capacity (Ropivacaine 0.5%: 40% +/- 17%, Ropivacaine 0.75%: 41% +/- 22%, mepivacaine 2%: 39% +/- 21%) and forced expiratory volume at 1 s (Ropivacaine 0.5%: 30% +/- 19%, Ropivacaine 0.75%: 38% +/- 26%, mepivacaine 2%: 40% +/- 10%). We conclude that, when performing IBP anesthesia, 0.5% Ropivacaine does not decrease the incidence of ipsilateral paresis of the hemidiaphragm compared with 0.75% Ropivacaine and 2% mepivacaine. IMPLICATIONS: During the first 30 min after placing interscalene brachial plexus anesthesia, 0.5% Ropivacaine does not provide clinically relevant advantages in terms of pulmonary function changes compared with either 0.75% Ropivacaine or 2% mepivacaine. However, 0.75% Ropivacaine allows a short onset, similar to that of mepivacaine, with long postoperative analgesia.
Alessandra Casati - One of the best experts on this subject based on the ideXlab platform.
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adding clonidine to the induction bolus and postoperative infusion during continuous femoral nerve block delays recovery of motor function after total knee arthroplasty
Anesthesia & Analgesia, 2005Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, F Vinciguerra, G Cappelleri, Marta Putzu, Jacques E ChellyAbstract:Weevaluatedtheeffectsofaddingclonidineforcontinuous peripheral nerve infusions. Sixty patients undergoing total knee arthroplasty under combined singleinjection sciatic block and continuous femoral infusion were randomly allocated to three groups: block induction with 0.75% Ropivacaine followed by 0.2% Ropivacaine (group control; n 20); block induction with 0.75% Ropivacaine and 1 g/kg clonidine followed by 0.2%Ropivacaine(groupcloni-bolus;n20),andblock
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, G Aldegheri, L Magistris, G Fanelli, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:UNLABELLED To evaluate 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 1 microg/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 measured 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; 25th-75th percentiles: 11. 8-14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th-75th percentiles: 13.5-17.8 h) (P = 0.038). We conclude that adding 1 microg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. IMPLICATIONS This prospective, randomized, double-blinded study demonstrated that, when providing combined sciatic-femoral nerve block for hallux valgus repair, the addition of 1 microg/kg clonidine to 0.75% Ropivacaine prolongs the duration of postoperative analgesia by 3 h, with only a slight and short-lived increase in the degree of sedation and no hemodynamic adverse effects.
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, L Magistris, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:To evaluate 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 5 15) or 0.75% Ropivacaine plus 1 mg/kg clonidine (group RopivacaineClonidine, n 5 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 measured 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; 25th‐75th percentiles: 11.8 ‐14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th‐75th percentiles: 13.5‐17.8 h) (P 5 0.038). We conclude that adding 1 mg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. (Anesth Analg 2000;91:388 ‐92)
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interscalene brachial plexus anaesthesia with 0 5 0 75 or 1 Ropivacaine a double blind comparison with 2 mepivacaine
BJA: British Journal of Anaesthesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Eleonora Colnaghi, Giangiacomo TorriAbstract:We have compared interscalene brachial plexus block performed with Ropivacaine or mepivacaine in 60 healthy patients undergoing elective shoulder surgery. Patients were allocated randomly to receive interscalene brachial plexus anaesthesia with 20 ml of 0.5% Ropivacaine ( n = 15), 0.75% Ropivacaine ( n = 15), 1 % Ropivacaine ( n = 15) or 2% mepivacaine ( n = 15). Readiness for surgery (loss of pinprick sensation from C4 to C7 and inability to elevate the limb from the bed) was achieved sooner with 1% Ropivacaine (mean 10 (sd 5) min) than with 0.5% Ropivacaine (22 (7) min) ( P P P
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pulmonary function changes after interscalene brachial plexus anesthesia with 0 5 and 0 75 Ropivacaine a double blinded comparison with 2 mepivacaine
Anesthesia & Analgesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Giangiacomo TorriAbstract:UNLABELLED: The purpose of this investigation was to compare, in a prospective, double-blinded fashion, 0.5% and 0.75% Ropivacaine with 2% mepivacaine to determine their effects on respiratory function during interscalene brachial plexus (IBP) anesthesia. With ethical committee approval and written, informed consent, 30 healthy patients presenting for elective shoulder capsuloplastic or acromioplastic procedures were randomized to receive IBP anesthesia by 20 mL of either 0.5% Ropivacaine (n = 10), 0.75% Ropivacaine (n = 10), or 2% mepivacaine (n = 10). Block onset time, pulmonary function variables, ipsilateral hemidiaphragmatic motion (ultrasonographic evaluation), and first requirement of postoperative analgesic were evaluated. Surgical anesthesia (loss of pinprick sensation from C4 to C7 and motor block of the shoulder joint) was achieved later with 0.5% Ropivacaine than with either 0.75% Ropivacaine or 2% mepivacaine (P < 0.05), whereas the first pain medication was requested later with both Ropivacaine concentrations than with mepivacaine (P < 0.0005). No differences in quality of the block or patient acceptance were observed in the three groups. All 30 patients had ipsilateral hemidiaphragmatic paresis and large mean decreases in forced vital capacity (Ropivacaine 0.5%: 40% +/- 17%, Ropivacaine 0.75%: 41% +/- 22%, mepivacaine 2%: 39% +/- 21%) and forced expiratory volume at 1 s (Ropivacaine 0.5%: 30% +/- 19%, Ropivacaine 0.75%: 38% +/- 26%, mepivacaine 2%: 40% +/- 10%). We conclude that, when performing IBP anesthesia, 0.5% Ropivacaine does not decrease the incidence of ipsilateral paresis of the hemidiaphragm compared with 0.75% Ropivacaine and 2% mepivacaine. IMPLICATIONS: During the first 30 min after placing interscalene brachial plexus anesthesia, 0.5% Ropivacaine does not provide clinically relevant advantages in terms of pulmonary function changes compared with either 0.75% Ropivacaine or 2% mepivacaine. However, 0.75% Ropivacaine allows a short onset, similar to that of mepivacaine, with long postoperative analgesia.
G Aldegheri - One of the best experts on this subject based on the ideXlab platform.
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adding clonidine to the induction bolus and postoperative infusion during continuous femoral nerve block delays recovery of motor function after total knee arthroplasty
Anesthesia & Analgesia, 2005Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, F Vinciguerra, G Cappelleri, Marta Putzu, Jacques E ChellyAbstract:Weevaluatedtheeffectsofaddingclonidineforcontinuous peripheral nerve infusions. Sixty patients undergoing total knee arthroplasty under combined singleinjection sciatic block and continuous femoral infusion were randomly allocated to three groups: block induction with 0.75% Ropivacaine followed by 0.2% Ropivacaine (group control; n 20); block induction with 0.75% Ropivacaine and 1 g/kg clonidine followed by 0.2%Ropivacaine(groupcloni-bolus;n20),andblock
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, G Aldegheri, L Magistris, G Fanelli, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:UNLABELLED To evaluate 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 1 microg/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 measured 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; 25th-75th percentiles: 11. 8-14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th-75th percentiles: 13.5-17.8 h) (P = 0.038). We conclude that adding 1 microg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. IMPLICATIONS This prospective, randomized, double-blinded study demonstrated that, when providing combined sciatic-femoral nerve block for hallux valgus repair, the addition of 1 microg/kg clonidine to 0.75% Ropivacaine prolongs the duration of postoperative analgesia by 3 h, with only a slight and short-lived increase in the degree of sedation and no hemodynamic adverse effects.
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, L Magistris, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:To evaluate 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 5 15) or 0.75% Ropivacaine plus 1 mg/kg clonidine (group RopivacaineClonidine, n 5 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 measured 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; 25th‐75th percentiles: 11.8 ‐14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th‐75th percentiles: 13.5‐17.8 h) (P 5 0.038). We conclude that adding 1 mg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. (Anesth Analg 2000;91:388 ‐92)
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interscalene brachial plexus anaesthesia with 0 5 0 75 or 1 Ropivacaine a double blind comparison with 2 mepivacaine
BJA: British Journal of Anaesthesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Eleonora Colnaghi, Giangiacomo TorriAbstract:We have compared interscalene brachial plexus block performed with Ropivacaine or mepivacaine in 60 healthy patients undergoing elective shoulder surgery. Patients were allocated randomly to receive interscalene brachial plexus anaesthesia with 20 ml of 0.5% Ropivacaine ( n = 15), 0.75% Ropivacaine ( n = 15), 1 % Ropivacaine ( n = 15) or 2% mepivacaine ( n = 15). Readiness for surgery (loss of pinprick sensation from C4 to C7 and inability to elevate the limb from the bed) was achieved sooner with 1% Ropivacaine (mean 10 (sd 5) min) than with 0.5% Ropivacaine (22 (7) min) ( P P P
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pulmonary function changes after interscalene brachial plexus anesthesia with 0 5 and 0 75 Ropivacaine a double blinded comparison with 2 mepivacaine
Anesthesia & Analgesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Giangiacomo TorriAbstract:UNLABELLED: The purpose of this investigation was to compare, in a prospective, double-blinded fashion, 0.5% and 0.75% Ropivacaine with 2% mepivacaine to determine their effects on respiratory function during interscalene brachial plexus (IBP) anesthesia. With ethical committee approval and written, informed consent, 30 healthy patients presenting for elective shoulder capsuloplastic or acromioplastic procedures were randomized to receive IBP anesthesia by 20 mL of either 0.5% Ropivacaine (n = 10), 0.75% Ropivacaine (n = 10), or 2% mepivacaine (n = 10). Block onset time, pulmonary function variables, ipsilateral hemidiaphragmatic motion (ultrasonographic evaluation), and first requirement of postoperative analgesic were evaluated. Surgical anesthesia (loss of pinprick sensation from C4 to C7 and motor block of the shoulder joint) was achieved later with 0.5% Ropivacaine than with either 0.75% Ropivacaine or 2% mepivacaine (P < 0.05), whereas the first pain medication was requested later with both Ropivacaine concentrations than with mepivacaine (P < 0.0005). No differences in quality of the block or patient acceptance were observed in the three groups. All 30 patients had ipsilateral hemidiaphragmatic paresis and large mean decreases in forced vital capacity (Ropivacaine 0.5%: 40% +/- 17%, Ropivacaine 0.75%: 41% +/- 22%, mepivacaine 2%: 39% +/- 21%) and forced expiratory volume at 1 s (Ropivacaine 0.5%: 30% +/- 19%, Ropivacaine 0.75%: 38% +/- 26%, mepivacaine 2%: 40% +/- 10%). We conclude that, when performing IBP anesthesia, 0.5% Ropivacaine does not decrease the incidence of ipsilateral paresis of the hemidiaphragm compared with 0.75% Ropivacaine and 2% mepivacaine. IMPLICATIONS: During the first 30 min after placing interscalene brachial plexus anesthesia, 0.5% Ropivacaine does not provide clinically relevant advantages in terms of pulmonary function changes compared with either 0.75% Ropivacaine or 2% mepivacaine. However, 0.75% Ropivacaine allows a short onset, similar to that of mepivacaine, with long postoperative analgesia.
Guido Fanelli - One of the best experts on this subject based on the ideXlab platform.
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adding clonidine to the induction bolus and postoperative infusion during continuous femoral nerve block delays recovery of motor function after total knee arthroplasty
Anesthesia & Analgesia, 2005Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, F Vinciguerra, G Cappelleri, Marta Putzu, Jacques E ChellyAbstract:Weevaluatedtheeffectsofaddingclonidineforcontinuous peripheral nerve infusions. Sixty patients undergoing total knee arthroplasty under combined singleinjection sciatic block and continuous femoral infusion were randomly allocated to three groups: block induction with 0.75% Ropivacaine followed by 0.2% Ropivacaine (group control; n 20); block induction with 0.75% Ropivacaine and 1 g/kg clonidine followed by 0.2%Ropivacaine(groupcloni-bolus;n20),andblock
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, L Magistris, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:To evaluate 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 5 15) or 0.75% Ropivacaine plus 1 mg/kg clonidine (group RopivacaineClonidine, n 5 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 measured 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; 25th‐75th percentiles: 11.8 ‐14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th‐75th percentiles: 13.5‐17.8 h) (P 5 0.038). We conclude that adding 1 mg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. (Anesth Analg 2000;91:388 ‐92)
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interscalene brachial plexus anaesthesia with 0 5 0 75 or 1 Ropivacaine a double blind comparison with 2 mepivacaine
BJA: British Journal of Anaesthesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Eleonora Colnaghi, Giangiacomo TorriAbstract:We have compared interscalene brachial plexus block performed with Ropivacaine or mepivacaine in 60 healthy patients undergoing elective shoulder surgery. Patients were allocated randomly to receive interscalene brachial plexus anaesthesia with 20 ml of 0.5% Ropivacaine ( n = 15), 0.75% Ropivacaine ( n = 15), 1 % Ropivacaine ( n = 15) or 2% mepivacaine ( n = 15). Readiness for surgery (loss of pinprick sensation from C4 to C7 and inability to elevate the limb from the bed) was achieved sooner with 1% Ropivacaine (mean 10 (sd 5) min) than with 0.5% Ropivacaine (22 (7) min) ( P P P
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pulmonary function changes after interscalene brachial plexus anesthesia with 0 5 and 0 75 Ropivacaine a double blinded comparison with 2 mepivacaine
Anesthesia & Analgesia, 1999Co-Authors: Alessandra Casati, Guido Fanelli, Valeria Cedrati, Marco Berti, G Aldegheri, Giangiacomo TorriAbstract:UNLABELLED: The purpose of this investigation was to compare, in a prospective, double-blinded fashion, 0.5% and 0.75% Ropivacaine with 2% mepivacaine to determine their effects on respiratory function during interscalene brachial plexus (IBP) anesthesia. With ethical committee approval and written, informed consent, 30 healthy patients presenting for elective shoulder capsuloplastic or acromioplastic procedures were randomized to receive IBP anesthesia by 20 mL of either 0.5% Ropivacaine (n = 10), 0.75% Ropivacaine (n = 10), or 2% mepivacaine (n = 10). Block onset time, pulmonary function variables, ipsilateral hemidiaphragmatic motion (ultrasonographic evaluation), and first requirement of postoperative analgesic were evaluated. Surgical anesthesia (loss of pinprick sensation from C4 to C7 and motor block of the shoulder joint) was achieved later with 0.5% Ropivacaine than with either 0.75% Ropivacaine or 2% mepivacaine (P < 0.05), whereas the first pain medication was requested later with both Ropivacaine concentrations than with mepivacaine (P < 0.0005). No differences in quality of the block or patient acceptance were observed in the three groups. All 30 patients had ipsilateral hemidiaphragmatic paresis and large mean decreases in forced vital capacity (Ropivacaine 0.5%: 40% +/- 17%, Ropivacaine 0.75%: 41% +/- 22%, mepivacaine 2%: 39% +/- 21%) and forced expiratory volume at 1 s (Ropivacaine 0.5%: 30% +/- 19%, Ropivacaine 0.75%: 38% +/- 26%, mepivacaine 2%: 40% +/- 10%). We conclude that, when performing IBP anesthesia, 0.5% Ropivacaine does not decrease the incidence of ipsilateral paresis of the hemidiaphragm compared with 0.75% Ropivacaine and 2% mepivacaine. IMPLICATIONS: During the first 30 min after placing interscalene brachial plexus anesthesia, 0.5% Ropivacaine does not provide clinically relevant advantages in terms of pulmonary function changes compared with either 0.75% Ropivacaine or 2% mepivacaine. However, 0.75% Ropivacaine allows a short onset, similar to that of mepivacaine, with long postoperative analgesia.
Gianluca Cappelleri - One of the best experts on this subject based on the ideXlab platform.
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, G Aldegheri, L Magistris, G Fanelli, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:UNLABELLED To evaluate 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 1 microg/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 measured 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; 25th-75th percentiles: 11. 8-14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th-75th percentiles: 13.5-17.8 h) (P = 0.038). We conclude that adding 1 microg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. IMPLICATIONS This prospective, randomized, double-blinded study demonstrated that, when providing combined sciatic-femoral nerve block for hallux valgus repair, the addition of 1 microg/kg clonidine to 0.75% Ropivacaine prolongs the duration of postoperative analgesia by 3 h, with only a slight and short-lived increase in the degree of sedation and no hemodynamic adverse effects.
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small dose clonidine prolongs postoperative analgesia after sciatic femoral nerve block with 0 75 Ropivacaine for foot surgery
Anesthesia & Analgesia, 2000Co-Authors: Alessandra Casati, Guido Fanelli, G Aldegheri, L Magistris, P Beccaria, Gianluca Cappelleri, Giangiacomo TorriAbstract:To evaluate 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 5 15) or 0.75% Ropivacaine plus 1 mg/kg clonidine (group RopivacaineClonidine, n 5 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 measured 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; 25th‐75th percentiles: 11.8 ‐14.5 h) than in group Ropivacaine-Clonidine (16.8 h; 25th‐75th percentiles: 13.5‐17.8 h) (P 5 0.038). We conclude that adding 1 mg/kg clonidine to 0.75% Ropivacaine provided a 3-h delay in first request for pain medication after hallux valgus repair, with no clinically relevant side effects. (Anesth Analg 2000;91:388 ‐92)
