Effect of Clonidine Premedication on Blood Loss in Spine Surgery

Anvari, Zahra Taghipour; Afshar-Fereydouniyan, Nader; Imani, Farnad; Sakhaei, Mojgan; Alijani, Babak; Mohseni, Masood

doi:10.5812/aapm.2197

Cited by 33 publications

(32 citation statements)

References 27 publications

(21 reference statements)

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“…In McClain et al study, SA could reduce the amount of anesthesia drugs, length of surgery time, and other side effects in discus decompression surgery (34). Tetzlaff et al have also shown that in spinal surgeries, SA was a better choice for anesthesia compared to GA resulting in lower side effects (35).…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Spinal and General Anesthesia in Percutaneous Nephrolithotomy

et al. 2013

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BackgroundHemodynamic stability and blood loss reduction are subjects to further consideration in patients undergoing percutaneous nephrolithotomy (PNCL).ObjectivesThis study compared the preference of spinal anaesthesia (SA) or general anaesthesia (GA) in respect to mentioned concerns.Patients and MethodsIn this randomized clinical trial, 59 patients who underwent PCNL divided into SA and GA groups. 15-20 mg from intra-thecal bupivacaine 0.5%, and premedication of 0.01-0.02 mg from midazolam, were given to patients in SA group (n = 29). Patients in GA group (n = 30) received premedication of 1-2 µg/kg from fentanyl and 0.01-0.02 mg/kg from midazolam, and intravenously anaesthetized with 100 µg/kg/min of propofol and 0.5 mg/kg of atracurium, given by continuous infusion and N2O/O2 50%. Mean arterial pressure (MAP) and heart rate were recorded intra-operatively and during recovery.ResultsMAP and heart rate show no significant differences at designated time points between two groups (P > 0.05). Surgery time, anesthesia time, bleeding volume, and analgesic intake were significantly reduced in SA group (P < 0.05).ConclusionsIt seems that, in patients undergoing PNCL, SA is as effective and safe as GA. Patients who undergo PNCL under SA require smaller amounts of analgesic dose and show hemodynamic stability during surgery and recovery time. Also, SA technique provides decreased blood loss and shortened surgery as well as anesthesia times compared to GA.

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Section: Discussionmentioning

confidence: 99%

Comparison Between Spinal and General Anesthesia in Percutaneous Nephrolithotomy

et al. 2013

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“…But the results were unsatisfactory. 7 Intravenous clonidine given in dose up to 4 micrograms per kilogram body weight/kg B.W (mics/kg B.W.) had produced satisfactory and reliable hypotension in patients undergoing middle ear and nasal surgeries.…”

Section: Discussionmentioning

confidence: 99%

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Praveen¹,

R²

2016

jemds

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BACKGROUNDClonidine an ideal agent for hypotensive anaesthesia, also attenuates stress response to laryngoscopy, decreases requirement of inhalational anaesthetic agents, decreases postoperative analgesic requirements, prevents post-operative shivering. MATERIAL AND METHODS60 patients under 16-60 years age group posted for functional endoscopic sinus surgery (FESS) were randomly divided into 2 groups of 30 each. Placebo group (Group P) received 20 mL normal saline intravenously and Clonidine group (Group C) received 2.5 micrograms Clonidine per kilogram body weight in 20 mL saline intravenously 20 mins before surgery. Haemodynamic variability during surgery, intraoperative inhalational agent requirement and perioperative bleeding as assessed by surgeon, postoperative analgesic requirement and post-operative shivering were compared between two groups. RESULTSThere was statistically significant reduction in heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure in Group C compared to Group P. There was statistically significant decrease in requirement of Isoflurane, decreased bleeding from surgical site, decreased analgesic consumption and nil incidence of postoperative shivering in Group C compared to Group P. CONCLUSIONClonidine is an ideal agent for hypotensive anaesthesia as it has got other favourable effects along with controlled hypotension, as it was observed in this study.

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“…These may affect the duration and technical accuracy of procedures, which are of high importance in spinal surgeries, considering the proximity of operation field to neurological structures (1). Different methods have been used to minimize the operation field hemorrhage, including the use of local vasoconstrictors or inducing deliberate hypotension by means of antihypertensive agents, vasodilators, or the anesthetic drugs (1,2).…”

Section: Introductionmentioning

confidence: 99%

Ankle Sprains at a Military Male School: Taping Versus Bracing

Najafipour

Ahmadi

2014

J Arch Mil Med

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Background: Surgical treatment of lumbar intervertebral disc herniation is a critical procedure due to the proximity of the operation field to neural structures. Providing a bloodless field and optimizing surgeon vision is of high value in this regard. Total intravenous anesthesia with propofol and inhalation anesthesia with isoflurane are both used in spine surgeries. Both of these agents have vasodilator properties that could be benefited in inducing controlled hypotension as a blood sparing technique. We sought to compare propofol and isoflurane anesthesia in terms of intraoperative bleeding and hemodynamic changes. Methods: After obtaining ethics approval and informed consent, 88 Iranian patients with American society of anesthesiology score 1 and 2 were randomly divided into two groups. The ISO group received isoflurane and the PRO group received propofol as the main anesthetic agent. Hemodynamic changes, intraoperative bleeding, urinary output, and surgeon satisfaction score were recorded. Results: The two groups were similar in demographic characteristics (for age P = 0.072; for gender P = 0.286). The ISO group had significantly lower blood pressure after 30 minutes of anesthesia (P = 0.01). Intraoperative bleeding in terms of qualitative and quantitative measures was lower in the ISO group (P = 0.001). Isoflurane anesthesia was also associated with a higher surgeon satisfaction score (P = 0.01). Conclusions: Our findings showed that isoflurane as a volatile agent provides a bloodless field better than does propofol through TIVA.

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Effect of Clonidine Premedication on Blood Loss in Spine Surgery

Cited by 33 publications

References 27 publications

Comparison Between Spinal and General Anesthesia in Percutaneous Nephrolithotomy

Comparison Between Spinal and General Anesthesia in Percutaneous Nephrolithotomy

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Ankle Sprains at a Military Male School: Taping Versus Bracing

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