Cardiovascular and metabolic responses to clonidine and midazolam premedication

Pseudocholinesterase activity increases and heart rate variability decreases with preoperative anxiety

“…A common way to determine preoperative anxiety is the use of psychological assessment scores such as the hospital anxiety and depression scale [7,8] and self-rating anxiety scale [9] or, less time-consuming but less differentiated, a VAS [10,11]. All scoring systems used in our study have been established in the literature [7][8][9][10][11] for determination of preoperative anxiety and depression.…”

“…All scoring systems used in our study have been established in the literature [7][8][9][10][11] for determination of preoperative anxiety and depression. In our study the hospital anxiety and depression scale and the VAS showed a significant correlation with HR variability and correlated with each other.…”

“…Additionally, reports link anxiety to increased activity of plasma cholinesterase [3,4] and this may affect the dose requirement for drugs such as mivacurium which are dependant upon plasma cholinesterase for their metabolism [5,6]. Several tools for the evaluation of preoperative anxiety have been described, including the hospital anxiety and depression scale which is divided into two subscales measuring anxiety and depression [7,8], the self-rating anxiety scale [9] and a visual analogue scale (VAS) [10,11]. In addition to these psychological measures, one can objectively describe physiological alterations related to preoperative anxiety such as changes in sympathetic-vagal balance induced by preoperative anxiety by determinations of the heart rate (HR) variability [12,13] as well as catalytic activity of plasma cholinesterase.…”

A Comparative Study Of Intravenous Clonidine And Intravenous Dexmedetomidine Premedication On Cardiovascular Response To Ketamine Anesthesia In Patients Undergoing Dilatation & Curettage.

“…Levanen et al reported that premedication with dexmedetomidine is effective in attenuating the cardiostimulatory and post anaesthetic delerium effects of ketamine and reported its superiority over midazolam. Taittoven et al [21] compared clonidine and midazolam as premedication in ketamine anaesthesia and observed no difference in oxygen consumption, anxiolysis, energy expenditure and carbondioxide production. They also observed that clonidine improved hemodynamic stability as compared to midazolam.…”

A Comparison of the Effects of Dexmedetomidine and Propofol in Controlling the Hemodynamic Responses after Intubation: A Double-Blind, Randomized, Clinical Trial Study

“…These factors may cause potentially deadly risks such as cardiac ischemia, myocardial infarction and hemorrhagic cerebrovascular accident (CVA), so these issues enhance the importance of prescribing in patients [ 1 ]. Many drugs have been used to block hemodynamic responses such as opioids [ 2 ], vasoconstrictor drugs [ 3 ], beta receptor blockers [ 4 ] alpha receptor blockers [ 5 ] and benzodiazepines [ 6 ]. General anaesthesia includes those that may reduce blood pressure and reduce myocardial contractions, vasodilatation, and weaken the activity of the autonomic nervous system [ 7 ] [ 8 ] [ 9 ].…”