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To Compare lidocaine2%/Clonidine in Combination, With Bupivacaine 0.5 % Alone in Equal Volumes for Combined Sciatic-saphenous Nerve Block in Terms of Selectivity of Blockade

Information source: Cork University Hospital
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Bimalleolar Fractures of the Ankle.; Sciatic Nerve Block.; Saphenous Nerve Block.; Post Operative Analgesia Duration.

Intervention: Bupivacaine (Drug); Lidocaine (Drug)

Phase: Phase 4

Status: Completed

Sponsored by: Cork University Hospital

Official(s) and/or principal investigator(s):
George Shorten, FCARCSI PhD, Study Chair, Affiliation: Cork University Hospital, Cork, Ireland.

Summary

Clonidine as an adjuvant to local anaesthetics prolongs the postoperative analgesia. It is predominantly an alpha 2 agonist, but does have some alpha 1 activity. Clonidine alone produces analgesia. When administered centrally its effects are predominantly due to its alpha 2 activity. When administered peripherally it prolongs the analgesia through its vasoconstrictor effects and by reducing the clearance of local anaesthetic. Another possibility is that it prolongs analgesia of peripheral nerve blocks due to a hyperpolarisation current .Clonidine has been used successfully both for upper and lower limb blocks. Studies of clonidine for lower limb blocks have produced equivocal results . A major concern with the lower limb blocks is the risk of falls associated with prolonged motor blockade during early mobilisation. Clonidine has been shown to intensify and prolong the motor blockade produced by long acting local anaesthetics. Lidocaine when used in combination with clonidine can increase the duration of analgesia to 8-18 hrs. Greater doses of clonidine are associated with longer analgesia but with more side effects. Clonidine in a dose of 90 mcg administered with local anaesthetics can produce analgesia for up to 10 hrs with minimal side effects. The aim of this study is to compare lidocaine 2% + clonidine 1. 5mcg/kg with bupivacaine alone in terms of block selectivity for combined sciatic

- saphenous nerve block in patients under going semi elective foot/ankle procedures.

Clinical Details

Official title: To Compare lidocaine2%/Clonidine in Combination With Bupivacaine 0.5 % Alone in Equal Volumes for Combined Sciatic-saphenous Nerve Block in Terms of Selectivity of Blockade

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: Duration of postoperative sensory and motor block.

Secondary outcome: Onset time of block.

Eligibility

Minimum age: 18 Years. Maximum age: 80 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- ASA 1-3 patients scheduled to undergo semi elective ankle/foot surgery with regional

anaesthesia will be recruited. Exclusion Criteria:

- patient refusal,

- allergy to local anaesthetics,

- coagulopathy,

- malignancy or infection at the block performance site,

- significant peripheral neuropathy or neurologic disorder of the lower extremity or

any other contraindication to sciatic and saphenous nerve block,

- pregnancy,

- history of alcohol or drug dependency/abuse (defined as >40 IU/week),

- a history of significant cognitive or psychiatric disorder that may affect patient

assessment.

Locations and Contacts

Cork University Hospital, Cork 0000, Ireland
Additional Information

Starting date: October 2011
Last updated: November 17, 2013

Page last updated: August 23, 2015

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