Clonidina na cineangiocoronariografia: efeitos sedativos sobre a pressão arterial e freqüência cardíaca

Abstract

objective: To evaluate the effects of clonidine on heart rate (HR), and blood pressure (BP) as well as its sedative effect on patients submitted to a cineangiocardiography. Methods:A randomized, controlled, double blind, prospective clinical trial was conducted on 62 patients submitted to an elective cineangiocardiography. The patients were divided in two groups: the clonidine group, that were administered a 0.8 µg/kg dose of this drug and the control group, that were administered a 0.9% saline solution. Sedation was evaluated based on the Ramsay Scale and the administration of a 0.04 mg/kg dose of meperidine that was given to the patients who were agitated or anxious during the procedure. The invasive BP, HR and sedation score based on the Ramsay Scale were analyzed every 5 minutes and four different intervals were considered for the assessment: I1-start of the test; I2-5 minutes after the start of the test; I3-median time of the test and I4-end of the test. Results:The clonidine group presented better BP and HR stability and sedation efficacy while the control group presented a higher intake of meperidine (p<0.05). In the statistical analysis, the inference of the continuous variables was calculated using the Student's t-test or Mann-Whitney test and the c 2 or Fisher Exact Probability test was used for the categorical variables. Conclusion:This study demonstrated that clonidine was an efficient means to control BP and HR and provided a conscious sedation for patients submitted to a cineangiocardiography.

Dose efetiva de sedação em ecocardiograma transesofágico: relação com idade, área de superfície e função do ventrículo esquerdo

“…The Ramsay scale was used for the analysis of the patients' level of sedation, and effective sedation was standardized as the response to verbal stimulus alone or accompanied by tactile or auditory stimulus, corresponding to the scores 3 and 4 of the scale 14 ( Table 1). …”

Efeitos sedativos e cardiovasculares do midazolam e do diazepam, associados ou não a clonidina, em pacientes submetidos a estudos hemodinâmicos por suspeita de doença arterial coronariana

“…All these effects result in a lower myocardial oxygen requirement, an aspect that should be considered in patients with coronary heart disease 1,2 .…”

“…Alpha-2 agonists such as clonidine have been studied and their benefits on the autonomic control are evident 1,2 .…”

“…Few studies on sedation during coronary angiography are available, and data on the use of alpha-2 agonists are particularly poor [1][2][3] . Thus, the objective of this study was to evaluate the effects of clonidine, and to compare it to two benzodiazepines (midazolam and diazepam), and their combination, observing their effects on blood pressure (BP), HR, and sedation in patients undergoing coronary angiography.…”

Comparação dos efeitos do sufentanil e da clonidina administrados por via endovenosa para sedação em pacientes submetidos a cateterismo cardíaco

“…A bradicardia tem início minutos após a sua administração, podendo atingir um pico em até 60 minutos (KARHUVAARA et al, 1991;NASCIMENTO et al, 2006), fato que justificou o acompanhamento do paciente por, pelo menos, 90 minutos após a aplicação da mesma.…”