Journal of Nippon Medical School: Vol.71 No.2 page.105

Journal of Nippon Medical School

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ArticleTitle Effect of Oral Tizanidine on Local-anesthetic Infiltration Pain during Epidural Catheterization

AuthorList Kazuyuki Imanaga^1,2, Zen'ichiro Wajima¹, Tetsuo Inoue¹ and Ryo Ogawa³

Affiliation ¹Department of Anesthesia, Chiba-Hokusoh Hospital, Nippon Medical School
²Department of Anesthesia, Ebina General Hospital
³Department of Anesthesiology, Nippon Medical School

Language EN

Volume 71

Issue 2

Year 2004

Page 105-110

Received October 27, 2003

Accepted November 28, 2003

Keywords Tizanidine, infiltration pain of local anesthetic, epidural catheterization

Abstract
Purpose: Tizanidine is a clonidine derivative and has the same effects, such as sedation, anxiolysis and analgesic response. We evaluated the effect of tizanidine on infiltration pain during epidural catheterization.

Methods: Forty patients scheduled to undergo epidural anesthesia in elective surgery were randomly allocated into two groups. The control group received placebo 60 minutes before arrival in the operating room, and the tizanidine group received 3 mg of oral tizanidine as premedication 60 minutes before arrival in the operating room. Every patient was measured heart rate and blood pressure before receiving placebo or premedication and after arrival in the operating room. After an epidural catheter was indwelled, the patients were questioned about the infiltrating pain of local anesthetic, and the degree was assessed by means of visual analog scale score (VAS score, 0∼100 mm).

Results: Blood pressure in the operating room was significantly attenuated in the tizanidine group compared to the control group (148±21 mmHg vs 130±15 mmHg). Heart rate was not significantly different between the two groups. Rate-pressure product was significantly lower in the tizanidine group (11282±2960 vs 9592±2632). VAS score in the tizanidine group was significantly lower than that in the control group (P<0.001).

Conclusion: It was possible to reduce the infiltration pain of local anesthetic during epidural catheterization by oral administration of 3 mg of tizanidine as premedication. Blood pressure and rate-pressure product in the operating room were also attenuated by receiving tizanidine. Therefore, we recommend premedication with tizanidine for patients undergoing epidural catheterization.

Correspondence to Correspondence to Kazuyuki Imanaga, MD, Department of Anesthesia, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba-mura, Inba-gun, Chiba 270-1694, Japan
QZU02042@nifty.com

ArticleTitle	Effect of Oral Tizanidine on Local-anesthetic Infiltration Pain during Epidural Catheterization
AuthorList	Kazuyuki Imanaga^1,2, Zen'ichiro Wajima¹, Tetsuo Inoue¹ and Ryo Ogawa³
Affiliation	¹Department of Anesthesia, Chiba-Hokusoh Hospital, Nippon Medical School ²Department of Anesthesia, Ebina General Hospital ³Department of Anesthesiology, Nippon Medical School
Language	EN
Volume	71
Issue	2
Year	2004
Page	105-110
Received	October 27, 2003
Accepted	November 28, 2003
Keywords	Tizanidine, infiltration pain of local anesthetic, epidural catheterization
Abstract	Purpose: Tizanidine is a clonidine derivative and has the same effects, such as sedation, anxiolysis and analgesic response. We evaluated the effect of tizanidine on infiltration pain during epidural catheterization. Methods: Forty patients scheduled to undergo epidural anesthesia in elective surgery were randomly allocated into two groups. The control group received placebo 60 minutes before arrival in the operating room, and the tizanidine group received 3 mg of oral tizanidine as premedication 60 minutes before arrival in the operating room. Every patient was measured heart rate and blood pressure before receiving placebo or premedication and after arrival in the operating room. After an epidural catheter was indwelled, the patients were questioned about the infiltrating pain of local anesthetic, and the degree was assessed by means of visual analog scale score (VAS score, 0∼100 mm). Results: Blood pressure in the operating room was significantly attenuated in the tizanidine group compared to the control group (148±21 mmHg vs 130±15 mmHg). Heart rate was not significantly different between the two groups. Rate-pressure product was significantly lower in the tizanidine group (11282±2960 vs 9592±2632). VAS score in the tizanidine group was significantly lower than that in the control group (P<0.001). Conclusion: It was possible to reduce the infiltration pain of local anesthetic during epidural catheterization by oral administration of 3 mg of tizanidine as premedication. Blood pressure and rate-pressure product in the operating room were also attenuated by receiving tizanidine. Therefore, we recommend premedication with tizanidine for patients undergoing epidural catheterization.
Correspondence to	Correspondence to Kazuyuki Imanaga, MD, Department of Anesthesia, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba-mura, Inba-gun, Chiba 270-1694, Japan QZU02042@nifty.com