Document Detail


Intravenous clonidine infusion in infants after cardiovascular surgery.
MedLine Citation:
PMID:  18230064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to investigate the hemodynamic profile and heart rhythm in infants who were given intravenous clonidine infusion after prolonged analgesia/sedation following cardiac surgery. METHODS: This is a single center retrospective review. A total of 542 cardiovascular surgical procedures in infants aged 0-24 months with congenital heart disease were performed between 01/2003 and 12/2005 at the Deutsches Herzzentrum in Berlin. The majority received no long-term analgesia/sedation, but 50 (9%) of these infants received clonidine (dosed at 0.18-3.6 microg.kg(-1).h(-1)) for sedation and to reduce withdrawal symptoms such as CNS hyperactivation, hypertension, tachycardia, and fever. The hospital records of these infants were studied. RESULTS: Fifty infants (median age 5.0 months, median body weight 5.3 kg, 32 males/18 females) received prolonged analgesia/sedation to ensure hemodynamic stability. Clonidine infusion started on day 5 (median) after surgery. During clonidine treatment we found an age-related normalized profile of hemodynamic parameters with a reduction of heart rate and mean arterial pressure from the upper norm to the mean within 24 h (P < 0.001). In no case did clonidine cause low blood pressure resulting in additional therapy to reach the target blood pressure. There were no adverse effects on cardiac rhythm, especially no onset of atrioventricular block. Midazolam, fentanyl, and other opioids could be ended on day 4 of clonidine treatment. CONCLUSIONS: Although off-label, it is feasible to use clonidine infusions in infants in the PICU setting after cardiac surgery without hemodynamic problems arising.
Authors:
Anja Pohl-Schickinger; Julia Lemmer; Michael Hübler; Vladimir Alexi-Meskishvili; Matthias Redlin; Felix Berger; Brigitte Stiller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  18     ISSN:  1155-5645     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-01-30     Completed Date:  2008-04-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  217-22     Citation Subset:  IM    
Affiliation:
Department of Neonatology, University Hospital Charité, Berlin, Germany. anja.pohl@charite.de
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MeSH Terms
Descriptor/Qualifier:
Analgesia / methods
Analgesics / administration & dosage*
Analgesics, Opioid / adverse effects*
Blood Pressure / drug effects
Body Temperature
Clonidine / administration & dosage*
Female
Fentanyl / adverse effects
Heart Defects, Congenital / surgery*
Heart Rate / drug effects
Humans
Hypnotics and Sedatives / adverse effects*
Infant
Infant, Newborn
Infusions, Intravenous
Male
Midazolam / adverse effects
Retrospective Studies
Substance Withdrawal Syndrome / prevention & control*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Analgesics; 0/Analgesics, Opioid; 0/Hypnotics and Sedatives; 4205-90-7/Clonidine; 437-38-7/Fentanyl; 59467-70-8/Midazolam

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