Intrathecal and Oral Clonidine as Prophylaxis for Postoperative Alcohol Withdrawal Syndrome: A Randomized Double-Blinded Study

Dobrydnjov, Igor; Axelsson, Kjell; Berggren, Lars; Samarütel, J.; Holmström, Björn

doi:10.1213/01.ane.0000099719.97261.da

Cited by 33 publications

(18 citation statements)

References 23 publications

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“…They noted, at 72 h post-operatively, that clonidine exerted better control than diazepam in controlling symptoms. [10] In the present case, the patient was already in delirium tremens and the surgical procedure was a dire emergency; the patient was induced with sleep dose of Inj. thiopentone as the liver enzymes were near normal and microsomal enzyme induction was suspected.…”

Section: Discussionmentioning

confidence: 82%

Alcoholic delirium tremens with hollow viscus perforation scheduled for emergency laparotomy

et al. 2012

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Alcohol is a drug consumed at some time in life by up to 80% of the population according to western statistics. Wide differences in socioeconomic status in India contribute to various degrees and severity of alcoholism and its associated complications. The symptoms of alcohol withdrawal range from such minor ones as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens. Although alcohol withdrawal syndrome has been reported in the literature in post-operative periods and in Intensive Care Unit, there is paucity of information on treatment and preparation of a patient with alcohol withdrawal syndrome coming for emergency surgical procedures. The surgical stress and deranged liver function in such cases poses an additional challenge to the anaesthesiologist. Here, we report the successful management of a case of acute alcoholic delirium tremens who presented with hollow viscous perforation for emergency exploratory laparotomy.

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Section: Discussionmentioning

confidence: 82%

Alcoholic delirium tremens with hollow viscus perforation scheduled for emergency laparotomy

et al. 2012

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“…Dobrydnjov et al [8] evaluated the use of either intrathecal or oral clonidine to attenuate postoperative alcohol withdrawal syndrome in 45 alcoholdependent patients (daily use of ethanol >60 g) who had transurethral resection of the prostate performed under spinal anesthesia. The patients were randomized to receive preoperative oral diazepam, intrathecal clonidine, or oral clonidine.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine in the Treatment of Withdrawal Syndromes in Cardiothoracic Surgery Patients

Baddigam

Russo

et al. 2005

J Intensive Care Med

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Dexmedetomidine (Precedex, Abbott Laboratories, Abbott Park, IL) is an alpha 2 adrenergic agonist that possesses a high ratio of specificity for the alpha 2 versus the alpha 1 receptor. It is currently approved for the provision of sedation during mechanical ventilation in adults. Given previous experience with clonidine for the treatment of substance withdrawal and the preliminary anecdotal experience with dexmedetomidine, it appears that dexmedetomidine may be a useful agent for treatment of substance withdrawal in the intensive care setting. The authors present their experience with the use of dexmedetomidine to control withdrawal behavior in 3 patients following cardiothoracic surgery. Previous reports regarding the use of dexmedetomidine to treat withdrawal and its potential application in this clinical arena are reviewed.

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“…After baseline testing of blood pressure and heart rate, subjects received placebo, 75 µg clonidine, or 150 µg clonidine orally. Clonidine doses were based on previous studies [51], [52]. The decision-making test was repeated 90 min later.…”

Section: Methodsmentioning

confidence: 99%

Clonidine Improved Laboratory-Measured Decision-Making Performance in Abstinent Heroin Addicts

et al. 2012

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BackgroundImpulsivity refers to a wide spectrum of actions characterized by quick and nonplanned reactions to external and internal stimuli, without taking into account the possible negative consequences for the individual or others, and decision-making is one of the biologically dissociated impulsive behaviors. Changes in impulsivity may be associated with norepinephrine. Various populations of drug addicts all performed impulsive decision making, which is a key risk factor in drug dependence and relapse. The present study investigated the effects of clonidine, which decreased norepinephrine release through presynaptic alpha-2 receptor activation, on the impaired decision-making performance in abstinent heroin addicts.Methodology/Principal FindingsDecision-making performance was assessed using the original version of Iowa Gambling Task (IGT). Both heroin addicts and normal controls were randomly assigned to three groups receiving clonidine, 0, 75 µg or 150 µg orally under double blind conditions. Psychiatric symptoms, including anxiety, depression and impulsivity, were rated on standardized scales. Heroin addicts reported higher scores on the Barratt Impulsiveness Scale and exhibited impaired decision-making on the IGT. A single high-dose of clonidine improved the decision-making performance in heroin addicts.Conclusions/SignificanceOur results suggest clonidine may have a potential therapeutic role in heroin addicts by improving the impaired impulsive decision-making. The current findings have important implications for behavioral and pharmacological interventions targeting decision-making in heroin addiction.

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Intrathecal and Oral Clonidine as Prophylaxis for Postoperative Alcohol Withdrawal Syndrome: A Randomized Double-Blinded Study

Abstract: In this randomized, double-blinded study, clonidine 150 microg both intrathecally and orally prevented postoperative alcohol-withdrawal symptoms in alcohol-dependent men. The effect was superior to that with a single dose of diazepam 10 mg orally.

Cited by 33 publications

References 23 publications

Alcoholic delirium tremens with hollow viscus perforation scheduled for emergency laparotomy

Alcoholic delirium tremens with hollow viscus perforation scheduled for emergency laparotomy

Dexmedetomidine in the Treatment of Withdrawal Syndromes in Cardiothoracic Surgery Patients

Clonidine Improved Laboratory-Measured Decision-Making Performance in Abstinent Heroin Addicts

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