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Effects of oral clonidine premedication and postoperative i.v. infusion on haemodynamic and adrenergic responses during recovery from anaesthesia
Author(s) -
BERNARD J. M.,
BOURRÉLI B.,
HOMMÉRIL J. L.,
PINAUD M.
Publication year - 1991
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.1399-6576.1991.tb03241.x
Subject(s) - clonidine , medicine , anesthesia , premedication , hemodynamics , heart rate , blood pressure , placebo , norepinephrine , perioperative , mean arterial pressure , catecholamine , dopamine , alternative medicine , pathology
The effects of clonidine, a central alpha 2 ‐adrenoreceptor agonist, on haemodynamic and catecholamine changes were assessed during emergence from anaesthesia, a period which is associated with increased sympathetic nervous discharge, hypertension and tachycardia. According to a double‐blind randomized design, 32 patients received either clonidine, preoperatively given by oral route (3. 5 μg kg ‐1 ) and postoperatively by i. v. infusion (0. 3 μg‐kg ‐1 ‐h ‐1 ), or a placebo. Perioperative management was similar in both groups. Measurements were made in the recovery room, before starting clonidine or placebo infusions for evaluation of clonidine premedication, and then during infusion as follows: when core temperature reached 37°C; then 2 h, and 6 h later. Prior to starting infusions, mean blood pressure (88 ± 15 vs 103± 14 mmHg) (11. 7 ± 2. 0 vs 13. 7 ± 1. 9 kPa), heart rate (67 ±8 vs 87 ± 17 beats min ‐1 ) and plasma norepinephrine levels (462 ±393 vs 615 + 361 pg‐ml ‐1 ) were lower in the clonidine group. Only at the latest measurement (6 h after core temperature reached 37°C) did clonidine elicit significant effects. The values during clonidine infusion compared to placebo were at this time: mean blood pressure (73 ± 10 vs 86 ± 13 mmHg) (9. 7 ± 1. 3 vs 11. 5 ± 1. 7 kPa), heart rate (71±6 vs 93± 13 beats‐min ‐1 ) and plasma norepinephrine levels (240 ± 224 vs 451 ± 111 pg‐ml ‐1 ). Our results suggest that: 1) preoperative clonidine may improve the haemodynamic profile associated with anaesthetic discontinuation, but 2) i. v. infusion (0. 3 μg · kg ‐1 . h ‐1 ) did not prolong this effect during the early postoperative period in the face of the sympathetic nervous discharge of recovery.