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Effects of oral clonidine premedication on concentrations of Cortisol and monoamine neurotransmitters and their metabolites in cerebrospinal fluid and plasma
Author(s) -
POUTTU J.,
TUOMINEN M.,
SCHEININ M.,
ROSENBERG P. H.
Publication year - 1989
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1989.tb02876.x
Subject(s) - medicine , premedication , clonidine , cerebrospinal fluid , monoamine neurotransmitter , endocrinology , anesthesia , serotonin , receptor
Forty–two healthy male patients (aged 19–40 years), undergoing orthopaedic surgery under spinal anaesthesia (3 ml isobaric 0.5% bupivacaine), were given clonidine 4.5 μg kg–1 orally either 2 (Group I, n= 10) or 4 (Group II, n=10) hours before the operation, diazepam 0.15 mg kg–1 orally (Group III, n=10) or a placebo tablet (Group IV, n= 12) 2 h before the operation. Plasma concentrations of Cortisol, noradrenaline (NA), adrenaline (A), 3,4–dihydroxyphenylglycol (DHPG) and dihydroxyphenylacetic acid (DOPAC) were assayed from venous blood samples just before premedication and just before the spinal block. Cerebrospinal fluid (CSF) concentrations of Cortisol, tryptophan, 5–hydroxyindoleacetic acid and catecholamine metabolites were assayed from a sample taken before the spinal block. The plasma NA concentrations of the patients in the groups receiving clonidine decreased clearly compared with the other groups ( P < 0.05). The NA metabolite DHPG was also lower in Groups I and II than in Group III ( P < 0.05) after premedication. Plasma A concentrations were lower in Groups I and III than in Group IV ( P < 0.05). The CSF concentrations of the different substances were similar in all groups. In Group I the sensory blockade lasted significantly longer than in Group III (P<0.05) and the mean duration of motor blockade was longer in Group I than in Groups III and IV ( P < 0.05). Two patients in both clonidine groups developed bradycardia (heart rate <45 min–1) requiring atropine treatment. The mean lowest heart rate was lower in Group I than in Groups III and IV ( P < 0.05). The patients in Group II were more sedated than those in Group IV ( P < 0.05), but the degree of fear was similar in all groups. No correlations were found between sedation or fear and the level of any of the hormones or metabolites.