Document Detail

Oral clonidine premedication exacerbates hypotension following tourniquet deflation by inhibiting noradrenaline release.
MedLine Citation:
PMID:  15129595     Owner:  NLM     Status:  MEDLINE    
Clonidine premedication prevents tourniquet pain and reduces sympathetic nerve activity. We evaluated hemodynamic changes and catecholamine release following tourniquet deflation during spinal anesthesia in patients who received oral clonidine premedication. The final analysis included 24 otherwise healthy patients undergoing lower-limb surgery randomly assigned to two groups: those receiving approximately 5 micrograms/kg of oral clonidine 1 hr before anesthesia (clonidine group, n = 12), and those receiving no premedication (control group, n = 12). After lumbar anesthesia, a tourniquet was applied for approximately 60 minutes to each patient. Electrocardiogram, arterial blood pressure, and consumption of butorphanol for tourniquet pain were monitored. Blood samples were obtained at different times to measure serum concentration of catecholamine. In the clonidine group, mean blood pressure decreased from 87 +/- 7 mmHg at baseline to 65 +/- 10 mmHg after tourniquet deflation (P < 0.05). This peak reduction of mean blood pressure in the clonidine group was significantly lower than in the control group. After receiving clonidine premedication, the plasma noradrenaline concentrations in the clonidine group were significantly lower than those in the control group. Noradrenaline concentration increased in the control group from 162.3 +/- 89.2 pg/mL before tourniquet deflation to 199.3 +/- 95.7 pg/mL afterward (P < 0.01), but there was no significant change in noradrenaline concentration after tourniquet deflation in the clonidine group. We conclude that oral clonidine premedication exacerbated the reduction in mean blood pressure following tourniquet deflation by inhibiting noradrenaline release.
Koichi Maruyama; Shinhiro Takeda; Takashi Hongo; Noriyuki Kobayashi; Chol Kim; Ryo Ogawa
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of Nippon Medical School = Nippon Ika Daigaku zasshi     Volume:  71     ISSN:  1345-4676     ISO Abbreviation:  J Nippon Med Sch     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-05-07     Completed Date:  2004-06-29     Revised Date:  2012-09-25    
Medline Journal Info:
Nlm Unique ID:  100935589     Medline TA:  J Nippon Med Sch     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  44-50     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care, Nippon Medical School, Tokyo, Japan.
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MeSH Terms
Administration, Oral
Adrenergic alpha-Agonists / administration & dosage,  adverse effects*
Anesthesia, Spinal
Blood Pressure / drug effects
Clonidine / administration & dosage,  adverse effects*
Depression, Chemical
Hypotension / etiology*
Middle Aged
Norepinephrine / secretion*
Pain / drug therapy,  etiology
Preanesthetic Medication*
Prospective Studies
Shock / etiology
Tourniquets / adverse effects*
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 4205-90-7/Clonidine; 51-41-2/Norepinephrine

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