The effect on post-operative pain of intravenous clonidine given before induction of anaesthesia

Abstract

Background:Treatment of acute post-thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications.Aim:This study was designed to test the effect of pre-induction administration of clonidine, given as a single intravenous dose, on post-operative pain scores and fentanyl consumption in patients after thoracic surgery.Setting and Design:Tertiary referral centre. Prospective, randomised, double-blind, placebo-controlled trial.Methods:Sixty patients were randomly allocated to receive clonidine (3 mcg/kg) or saline pre-operatively before induction of anaesthesia. The primary endpoint was pain on coughing (visual analogue scale (VAS) 0–100 mm) 120 min after surgery, time to first analgesic injection in the post-anaesthesia care unit (PACU) and 24-h fentanyl consumption.Statistical Analysis:For between-group comparisons, t-test and U-test were used as appropriate after checking normality of distribution. The incidence of complications between the groups was compared by Fisher's exact test.Results:The post-operative VAS for the first 120 min and the fentanyl consumption at 24 h was significantly greater in the placebo group compared with the clonidine group (P<0.05). The sedation score was increased in the clonidine group during study drug infusion, but did not differ significantly on admission to the PACU.Conclusions:A single intravenous dose of clonidine (3 mcg/kg) given before induction of anaesthesia significantly reduced the post-operative VAS score in the initial period and fentanyl consumption during 24 h after thoracic surgery.

The efficacy of intravenous clonidine premedication to reduce surgical area bleeding in posterior lumbar spine fusion surgery

“…They observed significant incidences of bradycardia and hypotension in their study. Sahajananda & Rao [19] and Samantaray et al [21] studied the effect of intravenous clonidine at 3µg/kg observed no significant events like bradycardia and hypotension requires vasopressor, correlates better with our observation.…”

“…Many previous studies compared the effect of oral clonidine to produce blood less surgical field by its hypotensive action [14][15][16]. But study on intravenous clonidine was few and they analysed the effect of clonidine on reduction of hemodynamic stress response to laryngoscopy, maintaining controlled hypotension, hemodynamic stability intraoperatively, sedation, analgesia and postoperative shivering [17][18][19][20][21][22].…”

Effects of dexmedetomidine and clonidine as propofol adjuvants on intra-operative hemodynamics and recovery profiles in patients undergoing laparoscopic cholecystectomy: A prospective randomized comparative study

“…Hence, the dose of clonidine was selected on the basis of previous studies, which have sorted out the its most effective dose of for intra-operative use. [ 12 13 14 ] The dose of clonidine was considered equipotent to that of dexmedetomidine. Rapid administration of both clonidine and dexmedetomidine can lead to bradycardia and hypotension, so the bolus dose was administered over a period of 15 min followed by the infusion.…”

“…Rapid administration of both clonidine and dexmedetomidine can lead to bradycardia and hypotension, so the bolus dose was administered over a period of 15 min followed by the infusion. [ 10 13 ]…”

The Effect of Pre-Emptive Dexmedetomidine on the Incidence of Post-Thoracotomy Pain Syndrome in Patients Undergoing Coronary Artery Bypass Grafting

“…Treatment of PTPS is of particular importance not only to keep the patient comfortable but also to minimize postoperative pulmonary complications ( 4 ). PTPS often induces psychosocial stress and anxiety or depression.…”