Premedication with Oral and Transdermal Clonidine Provides Safe and Efficacious Postoperative Sympatholysis

@article{Ellis1994PremedicationWO,
  title={Premedication with Oral and Transdermal Clonidine Provides Safe and Efficacious Postoperative Sympatholysis},
  author={John E. Ellis and Greet Drijvers and Steven Pedlow and S P Laff and Matthew J. Sorrentino and Joseph F. Foss and Manish N. Shah and Jennifer Busse and Srinivas Shyam Prasad Mantha and James F. Mckinsey and Joachim Osiński and Ronald A. Thisted and Michael F. Roizen},
  journal={Anesthesia \& Analgesia},
  year={1994},
  volume={79},
  pages={1133–1140}
}
We studied 61 patients undergoing elective major non-cardiac surgery in a randomized, double-blind, placebo-control clinical trial to test the hypothesis that the addition of clonidine to a standardized general anesthetic could safely provide postoperative sympatholysis for patients with known or suspected coronary artery disease. Patients were allocated randomly to receive either placebo (n = 31) or clonidine (n = 30). The treatment group received premedication with a trans-dermal clonidine… Expand
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References

SHOWING 1-10 OF 23 REFERENCES
Clonidine premedication for coronary artery bypass grafting under high-dose alfentanil anesthesia: intraoperative and postoperative hemodynamic study.
TLDR
Intraoperative hemodynamic profile analyses showed a continuous increase in systemic vascular resistance and mean arterial pressure in the clonidine group from the time of skin incision until the onset of bypass, whereas the cardiac output profiles remained similar in the two groups. Expand
Intraoperative clonidine enhances postoperative morphine patient-controlled analgesia
TLDR
Clonidine provided better analgesia in men and in patients <65 yr of age and reduced the number of analgesic demands during the observation period, which resulted in a reduction in morphine delivered. Expand
Reduced Narcotic Requirement by Clonidine with Improved Hemodynamic and Adrenergic Stability in Patients Undergoing Coronary Bypass Surgery
TLDR
Perioperative treatment with clonidine reduced narcotic and anesthetic requirements, improved hemodynamics, reduced plasma catecholamines, and shortened the period of postoperative ventilation in patients undergoing coronary artery surgery. Expand
Oxygen uptake after major abdominal surgery: effect of clonidine.
TLDR
There were no differences among groups in the incidence of shivering and in the rate of increase of esophageal temperature, but oxygen uptake was lower in the clonidine group than in the placebo group, suggesting a contrasting pattern may be secondary to a reduction in the intensity of mean muscular tremor. Expand
Effects of clonidine on anesthetic drug requirements and hemodynamic response during aortic surgery.
TLDR
The authors conclude that the preoperative administration of clonidine decreased the need to supplement anesthetic, and modifies the profile of distribution of heart rate and blood pressure. Expand
Intramuscularly Administered Dexmedetomidine Attenuates Hemodynamic and Stress Hormone Responses to Gynecologic Laparoscopy
TLDR
Plasma concentrations of norepinephrine, epinephrine, 3,4-dihydroxyphenylglycol, Cortisol, and /β-endorphin increased less in the dexmedetomidine 2.4-/μg/kg group in response to tracheal intubation and surgery than in the saline solution group. Expand
Epidural Morphine Decreases Postoperative Hypertension by Attenuating Sympathetic Nervous System Hyperactivity
TLDR
The data suggest that sympathetic nervous system activity and not adrenal epinephrine or pituitary secretion of arginine vasopressin is responsible for the development of hypertension following aortic surgery and epidural narcotics appear to provide a means of attenuating this response. Expand
Effects of epidural administration of local anaesthetics or morphine on postoperative nitrogen loss and catabolic hormones
TLDR
Results suggested that an elevated sympathic activity, represented by increased noradrenaline excretion and elicited by painful nociceptive and sympathetic nervous afferents, is responsible for the postoperative nitrogen loss which is mediated by glucagon and cortisol. Expand
Perioperative cardiac morbidity
TLDR
Preliminary data suggest that postoperative risk factors for PCM may be at least as critical as intraoperative factors and the relationship of postoperative ischaemia to outcome is unknown. Expand
Postoperative myocardial damage in patients with coronary artery disease undergoing major non cardiac surgery
TLDR
Myocardial damage is maximal in the first 24 hr after surgery, and may not be adequately predicted by current risk indices, as well as observed with predicted myocardial morbidity. Expand
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