Document Detail


Preoperative oral dextromethorphan vs. clonidine to prevent tourniquet-induced cardiovascular responses in orthopaedic patients under general anaesthesia.
MedLine Citation:
PMID:  17202010     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Preoperative oral dextromethorphan and intravenous clonidine attenuate arterial pressure and heart rate increases during tourniquet inflation under general anaesthesia. The effect of preoperative oral clonidine on these variables has not been investigated. METHODS: We designed this study to compare the effect of preoperative oral dextromethorphan or clonidine on haemodynamic changes during tourniquet inflation in 75 patients undergoing lower limb surgery under general anaesthesia. Patients were randomly assigned into three groups: dextromethorphan 30 mg (n = 25), clonidine 3 microg kg(-1) (n = 25) and placebo (n = 25). Anaesthesia was maintained with isoflurane 1.2% and N2O 50% in oxygen with endotracheal intubation. Dextromethorphan, clonidine or placebo was given orally in a double-blinded fashion 90 min before induction of anaesthesia. Systolic, diastolic and mean arterial pressure and heart rate were measured at 0, 30, 45, 60 min after the start of tourniquet inflation, before tourniquet release and 20 min after tourniquet deflation. RESULTS: Systolic, diastolic and mean arterial pressure were significantly lower in the clonidine group compared with control after 45, 60 min tourniquet inflation and before tourniquet release (P < 0.05). Twenty minutes after deflation, diastolic and mean arterial pressure in the control group were still increased and significantly higher compared with the clonidine group (P < 0.05). Development of more than a 30% increase in systolic arterial pressure during tourniquet inflation was more frequent in the control group than in the other groups. CONCLUSIONS: Preoperative oral clonidine 3 microg kg(-1) significantly prevented tourniquet-induced systemic arterial pressure increase in patients under general anaesthesia better than oral dextromethorphan.
Authors:
A Honarmand; M R Safavi
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-01-04
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  24     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-16     Completed Date:  2007-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  511-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Isfahan University School of Medicine, Isfahan, Iran.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adolescent
Adult
Analgesics, Opioid / administration & dosage,  pharmacology*
Analysis of Variance
Anesthesia, General
Antihypertensive Agents / administration & dosage,  pharmacology*
Blood Pressure / drug effects*,  physiology
Clonidine / administration & dosage,  pharmacology*
Dextromethorphan / administration & dosage,  pharmacology*
Double-Blind Method
Female
Heart Rate / drug effects*,  physiology
Humans
Injections, Intravenous
Male
Middle Aged
Monitoring, Physiologic / methods
Orthopedic Procedures
Preoperative Care / methods
Prospective Studies
Time Factors
Tourniquets / adverse effects
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Antihypertensive Agents; 125-71-3/Dextromethorphan; 4205-90-7/Clonidine

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


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