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Clonidine as a sedative adjunct in intensive care.

Abstract：

:A 63-year-old man underwent distal oesophagectomy and proximal gastrectomy. Postoperatively, controlled ventilation was necessary for 53 days because of anastomotic leakage. Multiple sedative regimens proved to be inadequate. By contrast, a fentanyl-midazolam combination with continuous supplementation of clonidine 0.014 micrograms kg-1 min-1 (1.44 mg 70 kg-1 24 h-1) was very effective in terms of sedation and pain relief. During combined fentanyl-midazolam and clonidine infusion, cardiovascular depression gradually developed over several days necessitating the institution of a dobutamine infusion (dose: 8-12 micrograms kg-1 min-1). Four attempts of abrupt clonidine withdrawal were followed by sympathetic overshoot reactions consisting of tachycardia, hypertension, agitation, and sweating. Discontinuation of clonidine was finally possible after a 12-day weaning period.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Böhrer H,Bach A,Layer M,Werning P

doi

10.1007/BF01705163

subject

Has Abstract

pub_date

1990-01-01 00:00:00

pages

265-6

issue

4

eissn

0342-4642

issn

1432-1238

journal_volume

16

pub_type

杂志文章

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