Abstract
Many preoperative, intraoperative and postoperative interventions and management strategies are available and continue to evolve for reducing and managing postoperative pain. Different pharmacologic actions of preanaesthetic medication may be desirable depending upon specific perioperative conditions such as patient selection, surgical procedure or anaesthesia type. Benzodiazepines are probably still most frequently used, although a variety of pharmacological premedication is available. Among these choices, alpha-2 agonists offer useful effects that make these drugs an interesting alternative for preanesthetic medication. Objective. This study evaluates the effect of clonidine in comparison to midazolam premedication on postoperative pain. Material and method. In a prospective study, effects of clonidine (0,15 mg orally) and midazolam (7,5 mg orally) administered 60-90 minutes prior to estimated anaesthesia induction time were investigated in 40 ASA physical status I or II patients, with age between 18 and 75 years. The severity of postoperative pain was assessed immediately after the procedure 2nd, 6th, 12th and 24th hours after surgery using the visual analog scoring system (VAS score). Also, the total dose of administered analgesics during 24 hours after surgery and the interval between the surgery and the first request of analgesic were compared between the two groups. Results. Postoperative pain VAS during 24 hours after the surgery was significantly lower in clonidine group (Group C) compared to the midazolam group (Group M): Group C – 1.33 points, Group M – 2.3 points. The meantime between surgery and the first request of analgesic in clonidine group was of longer duration compared in midazolam group: Group C – 3.22 hours, Group M – 4.53 hours. Conclusion. Clonidine premedication reduces the severity of postoperative pain in patients undergoing elective spinal neurosurgery. Clonidine administration did not delay postoperative recovery.
Highlights
The practice of pharmacological premedication in anaesthesiology was initiated soon after ether and chloroform were introduced as general anesthetics in the middle of the 19th century
Postoperative pain VAS during 24 hours after the surgery was significantly lower in clonidine group (Group C) compared to the midazolam group (Group M): Group C – 1.33 points, Group M – 2.3 points
Clonidine premedication reduces the severity of postoperative pain in patients undergoing elective spinal neurosurgery
Summary
The practice of pharmacological premedication in anaesthesiology was initiated soon after ether and chloroform were introduced as general anesthetics in the middle of the 19th century. Opioids and anticholinergics were the first drugs used for anesthetic premedication, and barbiturates. The main effects of premedication was described at that time within a pro-. The current practice of anesthetic premedication has evolved into a generalized scheme that incorporates several aspects of patient care: decreasing preoperative anxiety, blocking intraoperative noxious stimulus, minimizing postoperative adverse effects of anaesthesia and surgery. The ideal of premedication is as illusory as using an ideal anesthetic technique. Rational use of premedication should be justified by: patient status, pre-existing medication, type of surgery, anesthetic agents and techniques used
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