Clonidine and cardiac surgery: Haemodynamic and metabolic effects, myocardial ischaemia and recovery

Clonidine may have beneficial effects in patients undergoing major surgery. We enrolled 156 patients having elective CABG surgery in a double-blind ra ndomized trial. Patients were randomized to receive either two doses of pla cebo (Group PP) or clonidine 5 mu g/kg (Group CC). Perioperative measuremen ts included haemodynamics, anaesthetic and analgesic drug usage, creatinine clearance, cortisol excretion recovery times and quality of life (SF-36) a fter surgery. Overall, there was no significant difference with time to tra cheal extubation (median [10-90 centile]): CC 7.1 (3.4-18) h vs PP 8.0(4.3- 17) h, P=0.70; but there was a higher proportion of patients extubated with in four hours: CC 20% vs. PP 8%, P=0.038. Clonidine resulted in a number of significant (P<0.05) haemodynamic changes, particularly pre-CPB: less tach ycardia and hypertension, more bradycardia and hypotension. Clonidine was a ssociated with a significant (P<0.05) reduction in anaesthetic drug usage, higher creatinine clearance lower cortisol excretion and improvement in som e aspects of quality of life. This study lends support to consideration Of clonidine therapy in patients undergoing CABG surgery.