ENOMOTO, M. M.; ASSIS, R. B.; http://lattes.cnpq.br/9313041879118650; http://lattes.cnpq.br/4781749134047883; ENOMOTO, Matheus Marinho.; ASSIS, Rafael Baptista de.
Abstract:
Introduction: Acute pain that presents after thoracic surgery involving thoracotomy has
a great impact in the surgical patient’s quality of life, and there are several trials
comparing post-thoracotomy analgesia techniques. Clonidine, as an adjuvant to local
anesthetics, extends and improves analgesia in several procedures. Purpose: Our aim
was to assess the efficacy of clonidine as an adjuvant for lidocaine in intercostal nerve
block on postoperative pain. Methods: randomized, double-blind, controlled trial, in
which individuals have been allocated into two groups by the drawing of alpha-numeric
codes which have been generated by a computer program. The trial has been
performed at the Hospital Regional de Emergência e Trauma Dom Luiz Gonzaga
Fernandes of Campina Grande(HRETDLGF-CG), during the period between August
of 2013 and May of 2014. Participants: 58 patients were considered eligible by the
inclusion criteria and submitted to tube thoracostomy with previous intercostal nerve
block. Intervention: Intercostal nerve block was performed prior to surgery using either
2 mililiters of 2% lidocaine with 1 mililiter of clonidine (150 micrograms) or 0,9% saline.
Primary Outcome: Improvement of at least 50% of the pain intensity as measured by
the Visual Analog Scale (VSA) in 0, 6, 12, 24 and 48 hours post-operatively. Secondary
Outcomes: Improvement of the pain in 0, 6, 12, 24 and 48 hours post-procedure, as
measured by the VSA. Results: 29 patients were randomized in each group: a control
group and an experimental group, but after follow-up losses, the experimental group
lost 1 individual. There was no statistically significant difference between the groups
concerning pain scores at 0, 6, 12, 24 or 48 hours post-procedure or improvement of
at least 50% of the VSA at 0, 6, 12, 24 or 48 hours post-intercostal nerve block.
Conclusion: It was not observed superiority of adding clonidine as an adjuvant for
intercostal nerve block on patients submitted to tube thoracostomy. However, more
trials are necessary to determine the real efficacy of clonidine as an adjuvant in
analgesia via peripheral nerve block. This trial was registered in the REBEC (Brazilian
rial Register) Platform, under the Trial Universal Number U1111-1171-0186. This
project was financed with own resources, there being no conflict of interest to declare.