Document Detail


Ventilatory effects of clonidine alone and in the presence of alfentanil, in human volunteers.
MedLine Citation:
PMID:  1599110     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clonidine, an alpha 2-adrenergic agonist, can potentiate opioid-induced analgesia. In a double-blind placebo-controlled study in human volunteers, we sought to determine whether clonidine also potentiates opioid-induced respiratory depression. Hypercapnic ventilatory responses (minute ventilation, mean inspiratory flow rate, and mouth occlusion pressure) were measured in five healthy male volunteers on two separate occasions (with or without clonidine, approximately 3.5 micrograms.kg-1 orally) under the following conditions: baseline, 2 h after clonidine/placebo (alfentanil concentration of 0), and during computer-controlled alfentanil infusions to approximate plasma concentrations of 5, 10, 20, 40, and 80 ng.ml-1. Plasma alfentanil concentrations were measured before and after each rebreathing test, and clonidine concentrations were measured after each rebreathing test. The end-tidal CO2 (PET(CO2)) was measured continuously. Data were analyzed by repeated-measures analysis of variance. The PET(CO2) and measured concentrations of alfentanil were included as covariates, and a compound symmetry error analysis was assumed. Statistical significance was achieved when P less than 0.05. For minute ventilation, mean inspiratory flow rate, and mouth occlusion pressure there was a statistically significant relationship to the covariates of PET(CO2) and plasma alfentanil concentration. Clonidine, when compared to placebo, caused a small but significant depression of mean inspiratory flow rate. There was similarly a small, but statistically insignificant, depression of minute ventilation by clonidine. The mouth occlusion pressure was not affected by clonidine treatment. Clonidine treatment did not potentiate alfentanil-induced respiratory depression. Although the combination of an opioid and an alpha 2-adrenergic agonist may act synergistically for the analgesic response, there is no synergistic effect by this drug combination on respiratory depression.
Authors:
D A Jarvis; S R Duncan; I S Segal; M Maze
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesiology     Volume:  76     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-07-09     Completed Date:  1992-07-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  899-905     Citation Subset:  AIM; IM    
Affiliation:
Stanford University Medical Center, California.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alfentanil / pharmacology*
Clonidine / pharmacology*
Depression, Chemical
Humans
Male
Respiration / drug effects*
Grant Support
ID/Acronym/Agency:
GM 30232/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
4205-90-7/Clonidine; 71195-58-9/Alfentanil

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


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