Clonidine Facilitates Controlled Hypotension in Adolescent Children

Hackmann, Thomas; Friesen, Marvin; Allen, S. L.; Precious, David S.

doi:10.1213/01.ane.0000052713.72875.13

Cited by 22 publications

(11 citation statements)

References 21 publications

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“…Although clonidine has been used successfully as an adjunct for hypotensive techniques (2-5), another study found a contradictory effect of clonidine on intraoperative bleeding (12). Comparable to our findings, a study on 40 patients undergoing middle-ear surgery showed that clonidine improved the operative field (13).…”

Section: Discussionsupporting

confidence: 69%

Premedication with oral clonidine decreases intraoperative bleeding and provides hemodynamic stability in cesarean section

Ebneshahidi¹,

Mohseni

2011

Anesth Pain

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Background: Intentional lowering of blood pressure helps to produce a desirably clean surgical field. Many drugs can be used to induce a hypotensive state, but due to their high potency and rapid effect, drugs that more easily and safely control the induction of hypotension are desirable. Objectives: To investigate the effects of premedication with oral clonidine on intraoperative bleeding and hemodynamic variables in patients undergoing cesarean sections. Patients and Methods: A total of 110 patients classified as American Society of Anesthesiologists (ASA) physical status I and II and who were scheduled for elective cesarean section under general anesthesia were enrolled. The patients were randomized to receive either oral clonidine (0.2 mg) or identical-looking placebo tablets 90 minutes before arriving at the operating room. Induction of anesthesia was performed by the same standard protocol in all patients. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were recorded before and after induction; immediately after intubation; 5, 10, and 15 minutes thereafter; at the time of extubation; and one hour after the operation. The surgeons were asked to rate the quality of the operative field on a four-point scale that ranged from mild (1) to abundant bleeding (2). Results: Intraoperative SBP was lower in the clonidine group. After both intubation and extubation, the increases in SBP, DBP, and HR in clonidine-treated subjects were significantly less than the changes in the control patients. The amount of fentanyl given to control blood pressure and HR was significantly less in the clonidine group (18 ± 38 vs. 39 ± 53 μg, P = 0.02). The responses to the four-point scale indicated that intraoperative bleeding in the clonidine group was less than in the placebo group (1.2 ± 0.4 vs. 1.7 ± 0.6, P < 0.05). Conclusions: Premedication with oral clonidine can improve the hemodynamic management of cesarean cases.

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Section: Discussionsupporting

confidence: 69%

Premedication with oral clonidine decreases intraoperative bleeding and provides hemodynamic stability in cesarean section

Ebneshahidi¹,

Mohseni

2011

Anesth Pain

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“…This is similar to a study where clonidine was effective in reducing the requirement of fentanyl, isoflurane and beta-blockers. [13] This study conducted on adolescent children showed that clonidine reduced the requirement of fentanyl, isoflurane and labetalol. Our study did not show significant reduction in the requirement of isoflurane between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Intravenous clonidine as a part of balanced anaesthesia for controlled hypotension in functional endoscopic sinus surgery: A randomised controled trial

2017

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Background and Aims:Controlled hypotension with balanced anaesthesia minimises blood loss. This study was done to evaluate the effectiveness of intravenous clonidine as a single bolus dose to establish controlled hypotension during functional endoscopic sinus surgery (FESS).Methods:This randomised, double-blind, placebo-controlled study was done in a tertiary hospital in India. Sixty American Society of Anesthesiologists physical status I and II patients (18–65 years) undergoing FESS were randomly allocated to one of the two groups. Placebo group (group A, n = 30) received sterile water whereas the clonidine group (group B, n = 30) received 3μg/kg of clonidine intravenously, 30 min prior to induction of anaesthesia. The primary outcome was to achieve a target mean arterial blood pressure (MAP) of 55–65 mmHg intraoperatively. The secondary outcomes measured were requirement of additional fentanyl and metoprolol, intra-operative blood loss, surgeon's opinion on the surgical field, pain, sedation score and complications requiring treatment.Results:Target MAP was easily achieved in clonidine group as against the placebo group (P < 0.001). Significant reduction in intra-operative blood loss (P = 0.0449), a better surgical site scoring (P = 0.02), less requirement of additional hypotensive drugs and good analgesia (P = 0.01) were seen in clonidine group. The complication rates were similar in both the groups.Conclusion:Clonidine is effective in achieving controlled hypotension in patients undergoing FESS. It reduces intra-operative blood loss, requirement of additional hypotensive drugs, improves the surgical field and offers good analgesia without significant side effects.

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“…1, 2, 3 and graph 3 to 7 compared with baseline measurement, there was significantly less increase in heart rate and blood pressure in group II compared to group I. The same hypotensive effect of clonidine is elicited by Pandazi et al; Lee J et al; Gupta K et al; Singh S et al; Hackman et al; Farah et al; Sung C S et al [3], [19], [13], [6], [7], [5], [18] Clonidine for premedication has been used by other authors who have documented maintenance of stable haemodynamics during intubation, extubation, intraoperative and postoperative period. Clonidine as an oral, i.v.…”

Section: Discussionmentioning

confidence: 84%

Evaluation of Clinical Efficacy of Clonidine as an Adjuvant to General Anaesthesia in Elective Faciomaxillary and Aesthetic Face Surgery - The Prospective Randomized Single Blind Controlled Study

Singh¹,

Agrawal²,

Kang³

2014

jemds

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Clonidine Facilitates Controlled Hypotension in Adolescent Children

Cited by 22 publications

References 21 publications

Premedication with oral clonidine decreases intraoperative bleeding and provides hemodynamic stability in cesarean section

Premedication with oral clonidine decreases intraoperative bleeding and provides hemodynamic stability in cesarean section

Intravenous clonidine as a part of balanced anaesthesia for controlled hypotension in functional endoscopic sinus surgery: A randomised controled trial

Evaluation of Clinical Efficacy of Clonidine as an Adjuvant to General Anaesthesia in Elective Faciomaxillary and Aesthetic Face Surgery - The Prospective Randomized Single Blind Controlled Study

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