Oral Clonidine Premedication Research Articles

The Effect Of Oral Clonidine Premedication On blood Loss And The Quality Of The Surgical Field During Endoscopic Sinus Surgery

The Effect Of Oral Clonidine Premedication On blood Loss And The Quality Of The Surgical Field During Endoscopic Sinus Surgery

Effect of oral clonidine premedication on perioperative hemodynamics and postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A prospective randomized double-blind placebo-controlled clinical trial

Abstract Background: Laryngoscopy, endotracheal intubation, and creation of pneumoperitoneum during laparoscopic cholecystectomy cause sympathetic stimulation manifesting as hypertension, tachycardia, arrhythmia, and myocardial ischemia. Methods: We undertook this study to determine the effect of oral clonidine premedication on perioperative hemodynamics, postoperative pain, and sedation for patients undergoing laparoscopic cholecystectomy. In this double-blinded randomized controlled trial, 100 American Society of Anesthesiologists Grades I and II patients scheduled for laparoscopic cholecystectomy were randomized into 2 groups to receive 100 μg tablet clonidine in Group I and ranitidine 150 mg tablet in Group II (control group) 90 min before induction of general endotracheal anesthesia. Effect on hemodynamic parameters, duration of analgesia, requirement of rescue analgesic, and sedation score was assessed. Data were expressed as mean ± standard deviation or number (proportion). Unpaired t-test and Chi-square test were applied wherever indicated. P < 0.05 was considered statistically significant. Results: Patients in the clonidine group had lower systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate values as compared to control group at all measured time intervals (P < 0.05). The duration of analgesia was prolonged in the clonidine group (256.6 ± 34.97 min vs. 103.4 ± 10.94 min, P = 0.000). Total amount (88.50 ± 29.11 mg vs. 165.00 ± 30.31 mg, P = 0.000) and number of doses (1.18 ± 0.39 vs. 2.20 ± 0.40, P = 0.000) of rescue analgesic requirement in 1st 24 h postoperative period were also lesser in clonidine group. The sedation score was higher in clonidine group just after extubation (2.24 ± 0.43) as compared to the placebo group (1.92 ± 0.40, P = 0.000) at 1 h of postoperative period. Conclusion: Premedication with 100 μg clonidine provides stable hemodynamics against stress response triggered by the creation of pneumoperitoneum, laryngoscopy, and endotracheal intubation in patients undergoing laparoscopic cholecystectomy and also prolongs the duration of postoperative analgesia with reduced requirement of rescue analgesics without causing prolonged postoperative sedation.

Effect of oral melatonin and oral clonidine premedication on attenuation of hemodynamic response to direct laryngoscopy and tracheal intubation: A randomized controlled trial

Background and aimsDirect laryngoscopy and endotracheal intubation act as powerful noxious stimuli causing stimulation of sympathetic nervous system. Hence the present study intended to evaluate and compare the role of oral melatonin and clonidine as premedication in attenuation of this hemodynamic response. MethodsA Prospective, randomized, double blinded, placebo-controlled study. A total of 120 participants, ASAI/II, belonging to age group 18–60 years, were selected in study, equally divided into three groups: Group M (Melatonin 6 mg), Group C (Clonidine 0.2 mg), and Group P (Placebo). The drugs were given 60 min prior to induction of general anesthesia. Vital parameters like HR, SBP, DBP, MAP, and RPP (rate pressure product) were recorded before study drug administration (baseline), 30 min after drug administration, before induction, before intubation, immediately after intubation (0 min); 1, 2, 3, 5, and 10 min after intubation. P value < 0.05 was considered significant. ResultsA total of 115 participants were included in the study, out of which 35 were in Group M, 40 in Group C, and 40 in Group P. 21(18.3 %) were males and 94(81.7 %) were females. The mean values were much lower in Group M and Group C as compared to Group P terms of HR, SBP, DBP, and RPP at the following timepoints: before intubation, 0,1,2,3,5,10 min after intubation (p < 0.05). ConclusionBoth oral melatonin and clonidine are excellent drugs as premedication for attenuation of hemodynamic response to direct laryngoscopy and endotracheal intubation. Also, there is much lesser need for intraoperative rescue propofol doses and antihypertensives.

Clonidine premedication in spinal anaesthesia: Effect on hemodynamic status and vasopressor response to ephedrine

Introduction: Premedication has an important role to play in modern day anaesthesia care. In recent years, clonidine is making a comeback as a premedicant. Our study deals with haemodynamic changes to ephedrine after oral clonidine premedication for spinal anaesthesia with or without concurrent administration of drugs.The purpose of the study is to know the effect of oral clonidine premedication on haemodynamic status including vasopressor response of ephedrine during spinal anaesthesia. Materials: This is a prospective randomized double blinded controlled study. Sixty adult patients belonging to ASA I scheduled for elective surgery under spinal anaesthesia were selected. The patients were randomly assigned to 2 groups.Oral clonidine 4 microgram/kg was administered to group A(Clonidine group, n equal to 30) and 90 and one tablet of vitamin (placebo) orally 90 minutes was administered to group B (Control group, n equal to 30)90 minutes prior to anaesthesia. On the morning of surgery, blood pressure was measured before premedication and 90 minutes later. Sedation and anxiolysis were scored during clonidine premedication and 90th minute afterwards. When SBP decreased to 80% of the pre-spinal value, bolus IV injection of ephedrine 0.1 mg/kg was administered. After ephedrine injections, blood pressure and heart rate were recorded at 1 minute interval for 10 minutes. Results: Group A patients were found to have low SBP, DBP, MBP and HR when compared to group B. Intravenous ephedrine augmented blood pressure more than the control group. Statistically significant difference was found for SBP after 5 minutes, for MBP after 4 minutes of ephedrine administration and no significant difference was found for DBP. Conclusion: We conclude from our study that clonidine administered orally in a dose of 4 microgram/kg as a premedicant increases the pressor responses to IV injection ephedrine 0.2 mg/kg in patients with subarachnoid block.

A Study of the Effect of Pre-emptive Oral Clonidine on Intraoperative Haemodynamics and Surgical Field Quality During Functional Endoscopic Sinus Surgery Under General Anaesthesia.

Introduction For endoscopic sinus surgery for rhinosinusitis, pre-emptive Alpha 2 agonist clonidine has been used to reduce sympathetic output, which lowers blood pressure and consequentlysurgical bleeding. The aim of this study was to analyze the effects of oral clonidine premedication in patients undergoing functional endoscopic sinus surgery. Methods This study was performed between December 2020 to November 2022 among two groups of 30 patients each: clonidine (200 μgm oral) and placebo. Parameters were recorded at baseline, 60 mins after administering the drugs, at induction, and at minutes five, 10, 20, 30, 45, 60, 75, 105, and 120. Six-point average category scale for bleeding was studied. IBMSPSSStatistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States) was used for statistical analysis, and p < 0.05 was considered significant. Results Demographic criteria were statisticallynon-significant. Heart rate (HR) and mean arterial pressure (MAP) were statistically non-significant at baseline and the 120th min mark, and were significant at other time intervals. The blood loss grading was less in the clonidine group, and the difference was found to be statistically significant (P < 0.001). Conclusion Pre-emptive oral clonidine 200 mcg 60 min prior to induction was found to reduce surgical bleeding by controlling haemodynamics.

Effect of oral clonidine premedication on attenuating haemodynamic response to laryngoscopy and intubation during general anaesthesia

Background: Laryngoscopy with or without tracheal intubation evokes a defense mechanism that in turn alters patients’ haemodynamic responses in terms of increased heart rate (HR) and arterial blood pressure (ABP). Aim of current investigation was to study the efficacy of orally administered clonidine in a dose of 3-3.5 µg/kg given 90 minutes prior to scheduled time of the surgery, in attenuating the adverse haemodynamic responses to laryngoscopy and intubation of the trachea. Methods: Eighty normotensive patients between 20-60 years of age and having ASA grade I/II physical status were subdivided in two groups with 40 patients in each; test group received clonidine in a dose of 3-3.5 mcg/kg of body weight orally, 90 min before surgery and control group did not receive clonidine premedication. Induction was done with Thiopentone intravenous injection (5 mg/kg), followed by succinylcholine (1-1.5 mg/kg). Results: Haemodynamic responses in terms of parameters like HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) were recorded at pre induction and at 1, 2, 3, 5 minutes following laryngoscopy. The 1-minute post induction values of SBP, DBP, MAP were significantly less in clonidine group (p&lt;0.001) and the significance in listed parameters between two groups persisted until 5 minutes. Increase in HR was less in clonidine group than in control group. Conclusions: Premedication with oral clonidine 3-3.5 mcg/kg of body weight, 90 minutes before laryngoscopy and intubation is an efficient, simple and inexpensive method in attenuating the haemodynamic response generated due to laryngoscopy and intubation.

Effect of oral clonidine premedication on PR interval in patients undergoing rhinoplasty and functional endoscopic sinus surgery (FESS)

Background &amp; Objective: Clonidine, an alpha-2-agonist, plays a pivotal role in mitigating the sympathetic response during general anesthesia, thereby enhancing intraoperative hemodynamic stability. Despite its recognized benefits, reports of adverse cardiopulmonary effects have surfaced. This study investigates the impact of oral clonidine administered as premedication on patients undergoing rhinoplasty or Functional Endoscopic Sinus Surgery (FESS), with a focus on assessing alterations in the PR interval observed in postoperative electrocardiograms (ECG).&#x0D; Methodology: A Randomized Clinical Trial (RCT) comprised fifty patients scheduled for rhinoplasty or FESS under general anesthesia. Each participant underwent a standard 12-lead ECG, followed by the administration of 300 µg oral clonidine 30 min prior to entering the operating room. Anesthesia induction adhered to a uniform protocol for all subjects. Comprehensive ECG monitoring throughout the surgical procedure and recovery period facilitated the recording of any observed changes. Six hours post-clonidine administration, a second standard 12-lead ECG was obtained and juxtaposed with the initial recording.&#x0D; Results: Analysis revealed a lengthening of the PR interval in 23 (46%) of the cases. Within this cohort, 21 instances exhibited a prolongation falling within the normal range (0.12-0.2 sec), while the remaining two cases displayed abnormal prolongation (&gt; 0.2 sec) (P &lt; 0.001).&#x0D; Conclusion: This investigation suggests that premedication with oral clonidine, in the patients undergoing rhinoplasty or functional endoscopic sinus surgery, has the potential to extend the PR interval.&#x0D; Key words: Clonidine; PR interval; Rhinoplasty; Functional Endoscopic Sinus Surgery&#x0D; Citation: Saeed R, Qazi ZUS, Shah SMA, Bukhari S, Kanwal R, Kakepotto IA. Effect of oral clonidine premedication on PR interval in patients undergoing rhinoplasty and functional endoscopic sinus surgery (FESS). Anaesth. pain intensive care 2023;27(6):731−736; DOI: 10.35975/apic.v27i6.2343&#x0D; Received: August 24, 2023; Revised: November 03, 2023; Accepted: November 22, 2023

Effect of Oral Clonidine Premedication on Hemodynamic Stress Response to Laryngoscopy and Tracheal Intubation

Introduction: Different techniques have been tried to blunt undesirable hemodynamic effects like tachycardia, hypertension and dysarrhythmias during and after laryngoscopy and tracheal intubation.&#x0D; Objective: To find out the effect of oral clonidine premedication on hemodynamic stress response to laryngoscopy and tracheal intubation.&#x0D; Methodology: It was a prospective, randomized, double-blind comparative study conducted in patients undergoing laparoscopic cholecystectomy. Either oral clonidine 300 mcg (n=30) or placebo (n=30) was given one hour before the surgery. Depth of anesthesia was monitored and maintained at 40-60 level using bispectral index (BIS) monitor. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP) and oxygen saturation (SpO2) at baseline, one hour after premedication, on operation theatre (OT) table, just before and after one, two and five minutes after laryngoscopy and intubation were compared in Clonidine and placebo group using Paired t test and Chi-square test. SPSS was used for statistical analysis at P-value&lt;0.05&#x0D; Results: Hemodynamic variables like HR, SBP, DBP and MBP were significantly lower in the clonidine group compared to placebo just before and after the first five minutes of laryngoscopy and tracheal intubation (P&lt;0.05). Propofol requirement for induction of anesthesia was less in the clonidine group (95±31.8 mg vs 75.3±28.5 mg, p=0.014) compared to the placebo group. Adverse effects like hypotension and bradycardia were comparable in the groups. Time taken for extubation, time to follow verbal commands and time to orientation after surgery were similar in the both groups (P&gt;0.05).&#x0D; Conclusion: Oral clonidine premedication was effective in blunting undesirable hemodynamic stress response to laryngoscopy and tracheal intubation compared to the placebo.

English

BACKGROUND Bleeding during functional endoscopy sinus surgery (FESS) remains a main consideration. Even a small amount of blood may disturb the endoscopic view, increasing the likelihood of complications. So, we decided to compare the effects of clonidine and atenolol as oral premedication for hypotensive anaesthesia in patients undergoing FESS under general anaesthesia. The purpose of this study was to analyse and compare the efficacy of oral atenolol versus oral clonidine as premedication under general anaesthesia for induced hypotension in patients undergoing a functional endoscopic sinus surgery. METHODS The study included total 100 patients of age (18 – 60 years) [American Society of Anaesthesiologists (ASA grade I and II)] who were randomly divided into two groups of 50 each. Group - A (n = 50), a non-labelled clonidine tablet PO was given to the patients in the clonidine group in the dose of 2 mcg/kg at 7 pm the day before surgery and 4 mcg/kg two hours before surgery. Group - B (n = 50), a non-labelled atenolol 25 mg tablet was given PO to the patients in the atenolol group at 7 pm the day before surgery and also 2 hours before surgery. Induction and maintenance of general anaesthesia was performed by the same standard protocol for both groups. Hemodynamic effects [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), quality of surgical field, intraoperative complications, and post anaesthetic discharge score system (PADSS)] were recorded and statistically analysed. RESULTS The hemodynamic stability and good quality surgical field was obtained in both the groups. The lesser incidence of intraoperative complications recorded with atenolol gives it a more favourable profile when compared to clonidine. CONCLUSIONS We conclude that both oral clonidine and atenolol premedication provides superior and predictable perioperative hemodynamic control, reduces the requirement of hypotensive agents, and produces acceptable recovery characteristics. The lesser incidence of intraoperative complications recorded with atenolol gives it a more favourable profile when compared to clonidine. KEYWORDS Atenolol, Clonidine, Functional Endoscopic Sinus Surgery (FESS)

The Effect of Oral Clonidine at Different Doses on Post-Operative Analgesic and Hemodynamic Status in Upper Abdominal Surgery

Background: Upper abdominal surgery (like- hepatobiliary surgery, gastrectomy, esophagectomy, hepatictomy, and whipples operations that involve large surgical incisions) lead to severe postoperative pain that lead to higher doses of opoids use in post-operative period as a result incidence of unwanted side effect and respiratory complication increase hospital stay and morbidity. To reduce the use of opioids clonidine can be used as a multimodal analgesic approach. It is reported that clonidine 150mcg intravenous (I/V) produce a similar analgesic effect to morphine 5mg in patient after orthopedic surgery. Because of its dose, route, and surgical variation it is very much important to specify the dose for upper abdominal surgery.&#x0D; Material and methods: After considering the inclusion and exclusion criteria the patients were randomized to receive Group: A (2mcg/kg oral clonidine) and Group: B (4mcg/kg oral clonidine), one hour (60minutes) before surgery as an oral premedication. All groups were compared for preoperative analgesic, sedation and anxiety level along with changes of heart rate and mean arterial pressure prior to premedication and post-operative periods as follows VAS (visual analogue score) pain scores.&#x0D; Result: The post-operative pain measured on VAS showed Group A expressed highest VAS at 6thpost-operative hour Group –B showed highest VAS at 14th post-operative hour. So it is very clear to us that pethedine requirement of Group B (4mcg/kg oral clonidine) is less than Group A (2mcg/kg oral clonidine). The oral premedication with clonidine at 2 microgram per kg or 4 microgram per kg for postoperative analgesia and hemodynamic stability of elective upper abdominal surgery patients.&#x0D; Conclusion: As a part of multimodal analgesic approach, 4mcg/kg oral clonidine premedication is effective to perioperative pain control and keep stable the haemodynamic in upper abdominal surgery&#x0D; J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 131-135

Effect of Oral Clonidine Premedication in Diabetic Patients on Haemodynamic Status and Blood Glucose Homeostasis - A Comparative Study

Effect of Oral Clonidine Premedication in Diabetic Patients on Haemodynamic Status and Blood Glucose Homeostasis - A Comparative Study

A comparative study of effect of oral clonidine and oral metoprolol premedication on vital parameters in microscopic middle ear surgeries

A comparative study of effect of oral clonidine and oral metoprolol premedication on vital parameters in microscopic middle ear surgeries

Comparison of Oral Melatonin and Clonidine Premedication on Isoflurane Consumption and Postoperative Analgesia

Comparison of Oral Melatonin and Clonidine Premedication on Isoflurane Consumption and Postoperative Analgesia

A comparative study of effect of oral clonidine and oral metoprolol premedication on vital parameters in microscopic middle ear surgeries

A comparative study of effect of oral clonidine and oral metoprolol premedication on vital parameters in microscopic middle ear surgeries

Dose related effects of oral clonidine pre-medication on bupivacaine spinal anaesthesia.

The duration of action of sub-arachnoid block is short, and one of the ways to overcome this is the use of oral clonidine. 108 patients of ASA I and II, aged 18 to 65 years undergoing lower abdominal surgeries under spinal anaesthesia were randomized into three groups.. Control group A (n=36) no oral clonidine pre-medication, Group B (n=36) and group C (n=36) received 100 µg and 200 µg of oral clonidine pre-medication respectively, 1hr before spinal anaesthesia. Haemodynamic parameters were recorded. Sensory block, degree of motor blockage, and sedation were assessed. Clonidine prolonged the mean duration of motor block by 189.98±26.93 min (100µg) and 191.89±28.13 min (200µg) compared to 117.92±25.13 min in the control group p<0.05. The mean duration of analgesia was 188.19±35 min (100µg) and194±24.58 min (200µg) in the clonidine groups compared to 115.89±26.66 min in control group p<0.05. All the patients were awake in the control group while 71.43% and 100% were drowsy in groups B and C respectively. Oral clonidine produces better clinical effects on the onset and duration of Bupivacaine spinal anaesthesia.

Effects of Oral Clonidine Premedication on Spinal Subarachnoid Blockade with Hyperbaric Bupivacaine

Effects of Oral Clonidine Premedication on Spinal Subarachnoid Blockade with Hyperbaric Bupivacaine

Role of oral clonidine premedication for decreasing intra-operative bleeding with respect to scoring system at tertiary health care centre

Role of oral clonidine premedication for decreasing intra-operative bleeding with respect to scoring system at tertiary health care centre

Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Postoperative Sedation for Patients undergoing Laparoscopic Cholecystectomy

Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Postoperative Sedation for Patients undergoing Laparoscopic Cholecystectomy

Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Post Operative Analgesic Requirements for Patients Undergoing Laparoscopic Surgeries

Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Post Operative Analgesic Requirements for Patients Undergoing Laparoscopic Surgeries

Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Postoperative Sedation for Patients undergoing Laparoscopic Cholecystectomy

Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Postoperative Sedation for Patients undergoing Laparoscopic Cholecystectomy