Document Detail


Oral clonidine premedication attenuates the haemodynamic effects associated with ketamine anaesthetic induction in humans.
MedLine Citation:
PMID:  8403135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Induction of anaesthesia is often associated with undesirable variations in blood pressure and heart rate. Clonidine has been demonstrated to attenuate many of these undesirable effects when used as a premedicant. Other alpha 2 adrenergic agonists have been used to ameliorate the cardiostimulatory effects of ketamine in animals but there are few data on the use of this combination in humans. The effect of oral clonidine premedication, 5 micrograms.kg-1 on the haemodynamic changes induced by i.v. ketamine was studied in 42 patients volunteers. Ninety minutes before surgery, patients randomly received clonidine (C), diazepam (D), or a placebo (P) in a double-blinded fashion. Anaesthesia was induced with a ketamine infusion of 1 mg.kg-1 x min-1 until loss of consciousness. Heart rate and phasic blood pressure were measured noninvasively prior to induction, before and up to seven minutes after tracheal intubation. There were no differences in demographics or baseline vital signs among the three groups. With ketamine administration, increases in heart rate and blood pressure were less in those patients given C preoperatively than in those who received either D or P. The peak increase in mean blood pressure was 39% (C) versus 70% (D) and 55% (P) (P < 0.01). Heart rate increased by a maximum of 20% (C) versus 41% (D) and 46% (P) (P < 0.01). We conclude that oral clonidine attenuates the hyperdynamic effects of anaesthetic induction with i.v. ketamine.
Authors:
G J Doak; P C Duke
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  40     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-11-18     Completed Date:  1993-11-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  612-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, University of Manitoba, Winnipeg.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Anesthesia, Intravenous*
Blood Pressure / drug effects
Clonidine / administration & dosage,  adverse effects,  pharmacology*
Diazepam / administration & dosage,  adverse effects,  pharmacology
Double-Blind Method
Female
Hallucinations / chemically induced
Heart Rate / drug effects
Hemodynamics / drug effects
Humans
Ketamine / administration & dosage,  adverse effects,  pharmacology*
Male
Patient Satisfaction
Placebos
Preanesthetic Medication*
Time Factors
Chemical
Reg. No./Substance:
0/Placebos; 4205-90-7/Clonidine; 439-14-5/Diazepam; 6740-88-1/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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