Document Detail


The effect of clonidine premedication on hemodynamic responses to microlaryngoscopy and rigid bronchoscopy.
MedLine Citation:
PMID:  11004033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The usual hemodynamic response to laryngoscopy and bronchoscopy is an increase in heart rate and arterial blood pressure. Previous work has reported that 10%-18% of the patients develop ischemic ST segment changes during the procedure. Therefore, we performed a prospective, randomized, double-blinded study in 36 patients scheduled for elective microlaryngeal and bronchoscopic surgical procedures to evaluate the effects of 300-microg oral clonidine premedication (n = 18) or placebo (n = 18) on the hemodynamic alterations and the incidence of perioperative myocardial ischemic episodes. Myocardial ischemia was assessed by using continuous electrocardiographic monitoring, beginning 30 min before, and lasting until 24 h after the operation. During the procedure, patients receiving placebo exhibited a significant increase (mean +/- SD) in arterial blood pressure (the systolic increasing from 137+/-11 to 166+/-17 mm Hg, the diastolic increasing from 80+/-11 to 97+/-14 mm Hg) and heart rate (increasing from 79+/-15 to 97+/-12 bpm) compared with the baseline and with the clonidine group. A dose of 300-microg clonidine blunted the hemodynamic response to endoscopy. Ventricular arrhythmias were more frequent in patients who were not premedicated with clonidine. Two patients in the control group, but none in the clonidine group, had evidence of myocardial ischemia. These data should encourage routine premedication with clonidine in patients undergoing microlaryngoscopic and bronchoscopic procedures.
Authors:
I Matot; J Y Sichel; V Yofe; Y Gozal
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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:  Anesthesia and analgesia     Volume:  91     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-18     Completed Date:  2000-10-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  828-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia and Critical Care Medicine, Hadassah University School of Medicine, Jerusalem, Israel. matoth@cc.huji.ac.il
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / therapeutic use*
Aged
Arrhythmias, Cardiac / etiology
Blood Pressure / drug effects*
Bronchoscopy*
Chi-Square Distribution
Clonidine / therapeutic use*
Double-Blind Method
Electrocardiography, Ambulatory
Female
Heart Rate / drug effects*
Humans
Laryngoscopy / methods*
Male
Microsurgery / methods*
Middle Aged
Monitoring, Intraoperative
Myocardial Ischemia / etiology,  prevention & control
Placebos
Premedication*
Prospective Studies
Surgical Procedures, Elective
Sympatholytics / therapeutic use*
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Placebos; 0/Sympatholytics; 4205-90-7/Clonidine

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


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