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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2018; 6(16): 1136-1145
Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1136
Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1136
Effect of clonidine on the cutaneous silent period during spinal anesthesia
Sandra Graf Zupcic, Vladimira Vuletic, Clinic of Neurology, Clinical Hospital Centre Rijeka, Rijeka 51000, Croatia
Miroslav Zupcic, Tatjana Šimurina, Silvio Basic, Faculty of Medicine, J. J. Strossmayer University, Osijek 31000, Croatia
Miroslav Zupcic, Clinic of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Rijeka, Rijeka 51000, Croatia
Miroslav Zupcic, Vladimira Vuletic, Faculty of Medicine, University of Rijeka, Rijeka 51000, Croatia
Viktor Duzel, Department of Anaesthesia, Barking, Havering and Redbridge University Hospitals NHS Trust, London RM7 0AG, United Kingdom
Tatjana Šimurina, Department of Health Studies University of Zadar, Zadar 23000, Croatia
Tatjana Šimurina, Department of Anesthesiology and Intensive Care Medicine, General Hospital Zadar, Zadar 23000, Croatia
Milan Milošević, University of Zagreb, School of Medicine, Andrija Stampar School of Public Health WHO Collaborative Centre for Occupational Health, Zagreb 10000, Croatia
Silvio Basic, Department of Neurology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
Leonardo Kapural, Center for Clinical Research, Winston Salem, NC 27103, United States
Author contributions: Graf Zupcic S design of the work, acquisition, analysis and interpretation of data, drafting the work and revising it critically for important intellectual content; Zupcic M contributed through acquisition of data, study design, drafting the manuscript and revising it critically for important intellectual content; Duzel V and Šimurina T contributed through study design, revising it critically, data analysis, interpretation of the results, drafting and prepared the manuscript; Milošević M contributed through conception and design of the study, drafting the manuscript, data analysis and interpretation of the results; Basic S and Vuletic V contributed through data acquisition, interpretation of the results, conception of the study and drafting the manuscript; Kapural L contributed through data interpretation, conception of the study and drafting the manuscript; all co-authors critically reviewed the manuscript and gave their final approval of the version of the manuscript to be published.
Institutional review board statement: This trial was performed in accordance with the 1964 Helsinki declaration and its later amendments. Full approval for the trial was obtained by the local ethics committee of Clinical Hospital Dubrava (registration code 2391-1/15).
Clinical trial registration statement: This study is registered at https://clinicaltrials.gov/ct2/show/NCT03121261. The registration identification number is NTC03121261.
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: No conflicts-of-interest, financial or otherwise, are declared by the author(s).
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Miroslav Zupcic, MD, PhD, Assistant Professor, Clinic of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Rijeka, Kresimirova Ulica 42, Rijeka 51000, Croatia. miro_zupcic@yahoo.com
Telephone: +38-55-1407400 Fax: +38-55-1218407
Received: September 10, 2018
Peer-review started: September 10, 2018
First decision: October 11, 2018
Revised: October 17, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 26, 2018
Peer-review started: September 10, 2018
First decision: October 11, 2018
Revised: October 17, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 26, 2018
Core Tip
Core tip: Cutaneous silent period (CSP) is an oligosynaptic spinal inhibitory reflex. The results of our study show that intrathecal administration of levobupivacaine with added clonidine, in comparison to levobupivacaine alone, yields a significantly shorter CSP and a significantly longer CSP latency during block regression following subarachnoid block (SAB) application. Accordingly, we can conclude that during SAB regression, a small dose of intrathecally administered clonidine ameliorates the inhibitory tonus and accelerates the conduction in the oligosynaptic spinal circuit.