The effect of clonidine premedication on hemodynamic responses to microlaryngoscopy and rigid bronchoscopy

Citation
I. Matot et al., The effect of clonidine premedication on hemodynamic responses to microlaryngoscopy and rigid bronchoscopy, ANESTH ANAL, 91(4), 2000, pp. 828-833
Citations number
33
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANESTHESIA AND ANALGESIA
ISSN journal
00032999 → ACNP
Volume
91
Issue
4
Year of publication
2000
Pages
828 - 833
Database
ISI
SICI code
0003-2999(200010)91:4<828:TEOCPO>2.0.ZU;2-G
Abstract
The usual hemodynamic response to laryngoscopy and bronchoscopy is an incre ase in heart rate and arterial blood pressure. Previous work has reported t hat 10%-18% of the patients develop ischemic ST segment changes during the procedure. Therefore, we performed a prospective, randomized, double-blinde d study in 36 patients scheduled for elective microlaryngeal and bronchosco pic surgical procedures to evaluate the effects of 300-mu g oral clonidine premedication (n = 18) or placebo (n = 18) on the hemodynamic alterations a nd 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) c ompared with the baseline and with the clonidine group. A dose of 300-mu g clonidine blunted the hemodynamic response to endoscopy. Ventricular arrhyt hmias were more frequent in patients who were not premedicated with clonidi ne. Two patients in the control group, but none in the clonidine group, had evidence of myocardial ischemia. These data should encourage routine preme dication with clonidine in patients undergoing microlaryngoscopic and bronc hoscopic procedures.