Supplementation of retrobulbar block with clonidine in vitreoretinal surgery: effect on postoperative pain.

Author(s): Yazbeck-Karam VG, Siddik-Sayyid SM, Abi Nader EL, Barakat DE, Karam HS, Cherfane GM, Hussein JN, Aouad MT

Affiliation(s): Department of Anesthesiology, Rizk Hospital, Beirut, Lebanon.

Publication date & source: 2011-08, J Clin Anesth., 23(5):393-7.

Publication type: Research Support, Non-U.S. Gov't

STUDY OBJECTIVE: To evaluate the effect of clonidine when added to local anesthetics on duration of postoperative analgesia during retrobulbar block. DESIGN: Prospective, randomized controlled trial. SETTING: Operating room and Postanesthesia Care Unit of a university-affiliated hospital. SUBJECTS: 80 ASA physical status 1, 2, and 3 patients undergoing vitreoretinal surgery with or without scleral buckling. INTERVENTIONS: Patients in the control group (n = 40) received a retrobulbar block with 4.5 mL of lidocaine-bupivacaine and 0.5 mL of saline. Clonidine group patients (n = 40) received 4.5 mL of lidocaine-bupivacaine and 0.5 mug/kg of clonidine in a 0.5 mL volume. MEASUREMENTS: The time to first analgesic request, frequency of postoperative pain, and number of postoperative analgesic requests per patient were assessed. MAIN RESULTS: 37 patients in the control group (92.5%) versus 24 patients (60%) in the clonidine group reported pain postoperatively (P = 0.001), with a shorter time to first analgesic request noted in the control group (4.9 +/- 3 vs 11.9 +/- 5.3 hrs; P < 0.001). The median number of postoperative analgesic requests per patient during the first 24 hours was higher in the control group than the clonidine group [2 (0-3) vs. 1 (0-3); P < 0.001]. CONCLUSIONS: The addition of clonidine 0.5 mug/kg to the local anesthetics of a retrobulbar block for vitreoretinal surgery decreases the frequency of postoperative pain and prolongs the time of analgesia. Copyright (c) 2011 Elsevier Inc. All rights reserved.