Effects of intramuscular clonidine on hemodynamic and plasma beta-endorphin responses to gynecologic laparoscopy.

Abstract:

:Ninety women undergoing gynecologic laparoscopy were randomly given clonidine 3 or 4.5 micrograms/kg or saline intramuscularly 45-60 min prior to induction of anesthesia. Anesthesia was induced with thiopental 3.5 mg/kg and maintained with 0.3% end-tidal isoflurane in nitrous oxide and oxygen. The laparoscopy did not begin sooner than 20 min after tracheal intubation. Arterial blood pressure and heart rate were monitored with an automatic oscillometer. When compared with the baseline values, clonidine 4.5 micrograms/kg significantly (P less than 0.001) decreased the mean arterial pressure (MAP) measured before induction of anesthesia. In all three groups, blood pressure and heart rate increased after tracheal intubation and after beginning of laparoscopy (P less than 0.001), but the increments were significantly greater in the control group than in the study groups. During anesthesia alone without surgical stimulation, and again in the recovery room, MAP and heart rate were lower in the study groups than in the control group. Plasma beta-endorphin immunoreactivity (ir beta-E) was measured for ten control-group women and ten women receiving clonidine 4.5 micrograms/kg before premedication, before and after induction of anesthesia, during laparoscopy, and 1 h after the procedure. The plasma ir beta-E increased significantly after the beginning of laparoscopy in both the control group and those given clonidine, but the increase was significantly less (P less than 0.05) in the women premedicated with clonidine. The blunting effect of clonidine on hemodynamics and plasma beta endorphin may reflect a deeper level of anesthesia in those women receiving clonidine as preanesthetic medication or can be explained by an interaction of clonidine with endogenous opiates. The authors conclude that intramuscularly administered clonidine premedication effectively prevents the maximal hemodynamic responses to tracheal intubation and to gynecologic laparoscopy. Further clinical studies on the clinical importance of the role of clonidine preanesthetic medication are warranted.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Aho M,Lehtinen AM,Laatikainen T,Korttila K

doi

10.1097/00000542-199005000-00004

subject

Has Abstract

pub_date

1990-05-01 00:00:00

pages

797-802

issue

5

eissn

0003-3022

issn

1528-1175

journal_volume

72

pub_type

临床试验,杂志文章,随机对照试验
  • Dexamethasone changes brain monoamine metabolism and aggravates ischemic neuronal damage in rats.

    abstract:BACKGROUND:Glucocorticoids have been reported to aggravate ischemic brain damage. Because changes in the activities of various neuronal systems are closely related to the outcome of ischemic damage, the authors evaluated the effects of dexamethasone on the monoaminergic systems and ischemic neuronal damage. METHODS:Th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199902000-00028

    authors: Tsubota S,Adachi N,Chen J,Yorozuya T,Nagaro T,Arai T

    更新日期:1999-02-01 00:00:00

  • Mechanisms of differential axial blockade in epidural and subarachnoid anesthesia.

    abstract::The mechanisms of persistent differential blocks that accompany subarachnoid and epidural anesthesia are clarified here with the aid of two principles derived from in vitro study of individual myelinated axons: 1) conduction can leap two consecutive blocked nodes but not three, and 2) a fiber length with more than thr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198905000-00023

    authors: Fink BR

    更新日期:1989-05-01 00:00:00

  • Neuropathic Allodynia Involves Spinal Neurexin-1β-dependent Neuroligin-1/Postsynaptic Density-95/NR2B Cascade in Rats.

    abstract:BACKGROUND:Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000809

    authors: Lin TB,Lai CY,Hsieh MC,Jiang JL,Cheng JK,Chau YP,Ruan T,Chen GD,Peng HY

    更新日期:2015-10-01 00:00:00

  • Beneficial effects from beta-adrenergic blockade in elderly patients undergoing noncardiac surgery.

    abstract:BACKGROUND:Perioperative beta-blockade has been shown to improve long-term cardiac outcome in noncardiac surgical patients. A possible mechanism for the reduced risk of perioperative myocardial infarction is the attenuation of the excitotoxic effects of catecholamine surges by beta-blockade. It was hypothesized that be...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199912000-00020

    authors: Zaugg M,Tagliente T,Lucchinetti E,Jacobs E,Krol M,Bodian C,Reich DL,Silverstein JH

    更新日期:1999-12-01 00:00:00

  • Anesthetic mishaps: breaking the chain of accident evolution.

    abstract::Anesthesia and surgery are a risk for all, the healthy as well as the sick. While the prevention of adverse outcomes in healthy patients is paramount, enhancement of safety for critically ill patients is also essential, since they are more likely to suffer a SNO after a critical incident. Dangers originate from a vari...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:

    authors: Gaba DM,Maxwell M,DeAnda A

    更新日期:1987-05-01 00:00:00

  • The effects of CO2 on respiratory mechanics in anesthetized paralyzed humans.

    abstract:BACKGROUND:There is little information concerning the carbon dioxide-related effects on respiratory mechanics in anesthetized, paralyzed subjects; however, hypocapnia or hypercapnia is often permitted in patients with severe brain injury or acute respiratory distress syndrome. Therefore, the carbon dioxide dependence o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200104000-00013

    authors: D'Angelo E,Calderini IS,Tavola M

    更新日期:2001-04-01 00:00:00

  • Differential behavioral effects of peripheral and systemic morphine and naloxone in a rat model of repeated acute inflammation.

    abstract:BACKGROUND:It has been reported that opioid antinociceptive effects are enhanced in animal models of inflammation, but it remains unclear whether this sensitization to morphine is related to predominant central or peripheral increased effects. METHODS:The authors compared the behavioral effects of intraplantar and int...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200105000-00027

    authors: Perrot S,Guilbaud G,Kayser V

    更新日期:2001-05-01 00:00:00

  • Barbiturate anesthetics inhibit thromboxane-, potassium-, but not angiotensin-induced pulmonary vasoconstriction.

    abstract::Administration of the oxidant lipid peroxide tertiary butyl hydroperoxide (t-bu-OOH) in the isolated rabbit lung leads to acute pulmonary vasoconstriction, which is caused by the synthesis of thromboxane. The inhalational anesthetics, halothane, nitrous oxide, and cyclopropane, markedly enhance t-bu-OOH-induced pulmon...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198905000-00012

    authors: McShane AJ,Crowley K,Shayevitz JR,Michael JR,Adkinson NF Jr,Traystman RJ,Gurtner GH

    更新日期:1989-05-01 00:00:00

  • No evidence for blood flow redistribution with isoflurane or halothane during acute coronary artery occlusion in fentanyl-anesthetized dogs.

    abstract::The present study examines the postulate that isoflurane, in contrast to halothane, causes redistribution of blood flow away from an ischemic myocardial region through vasodilation of adjacent normally perfused myocardium. The study was performed in open-chest dogs anesthetized with fentanyl; ischemia was induced by o...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199111000-00018

    authors: Moore PG,Kien ND,Reitan JA,White DA,Safwat AM

    更新日期:1991-11-01 00:00:00

  • Propofol: relation between brain concentrations, electroencephalogram, middle cerebral artery blood flow velocity, and cerebral oxygen extraction during induction of anesthesia.

    abstract:BACKGROUND:The potential benefit of propofol dose regimens that use physiologic pharmacokinetic modeling to target the brain has been demonstrated in animals, but no data are available on the rate of propofol distribution to the brain in humans. This study measured the brain uptake of propofol in humans and the simulta...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-200212000-00006

    authors: Ludbrook GL,Visco E,Lam AM

    更新日期:2002-12-01 00:00:00

  • Lidocaine as an analgesic for experimental pain.

    abstract::The purpose of this study was to evaluate the analgesic contribution of intravenously administered lidocaine and to correlate it with blood levels of the drug. In a double-blind manner, 14 healthy male volunteers received saline solution or lidocaine, 0.2 per cent, at three increasingly greater rates of infusion on tw...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198001000-00005

    authors: Rowlingson JC,DiFazio CA,Foster J,Carron H

    更新日期:1980-01-01 00:00:00

  • Effects of isoflurane on cerebral autoregulation in dogs.

    abstract::The effect of decreased cerebral perfusion pressure (CPP) on regional cerebral blood flow (CBF) with radiolabeled microspheres in dogs receiving either 1.4% or 2.8% isoflurane following anesthesia induction with thiopental (12 mg/kg, iv bolus) was studied. Mean arterial blood pressure (MABP), cerebrospinal fluid press...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198810000-00008

    authors: McPherson RW,Traystman RJ

    更新日期:1988-10-01 00:00:00

  • Analgesic effects of intravenous lidocaine and morphine on postamputation pain: a randomized double-blind, active placebo-controlled, crossover trial.

    abstract:BACKGROUND:Phantom and stump pains, common sequelae of limb amputations, are significant impediments to rehabilitation of amputees. The pathophysiology and optimal treatment of postamputation pain states are unclear. While stump pain may result from neuromas in the stump, phantom pain is thought to be related to cortic...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200204000-00010

    authors: Wu CL,Tella P,Staats PS,Vaslav R,Kazim DA,Wesselmann U,Raja SN

    更新日期:2002-04-01 00:00:00

  • Cholinergic modulation of sevoflurane potency in cortical and spinal networks in vitro.

    abstract:BACKGROUND:Victims of organophosphate intoxication with cholinergic crisis may have need for sedation and anesthesia, but little is known about how anesthetics work in these patients. Recent studies suggest that cholinergic stimulation impairs gamma-aminobutyric acid type A (GABAA) receptor function. Because GABAA rece...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000267598.65120.f2

    authors: Grasshoff C,Drexler B,Hentschke H,Thiermann H,Antkowiak B

    更新日期:2007-06-01 00:00:00

  • Propofol has no direct effect on sinoatrial node function or on normal atrioventricular and accessory pathway conduction in Wolff-Parkinson-White syndrome during alfentanil/midazolam anesthesia.

    abstract:BACKGROUND:Propofol has been implicated as causing intraoperative bradyarrhythmias. Furthermore, the effects of propofol on the electrophysiologic properties of the sinoatrial (SA) node and on normal atrioventricular (AV) and accessory pathways in patients with Wolff-Parkinson-White syndrome are unknown. Therefore, thi...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-199504000-00011

    authors: Sharpe MD,Dobkowski WB,Murkin JM,Klein G,Yee R

    更新日期:1995-04-01 00:00:00

  • Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate.

    abstract::Dexmedetomidine (DMED) is a highly selective centrally acting alpha 2-adrenergic agonist thought to provide significant sedation without appreciable ventilatory effects. This double-blind, placebo-controlled experiment evaluated four dose levels of DMED (0.25, 0.5, 1.0, and 2.0 micrograms/kg intravenously over 2 min) ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199212000-00013

    authors: Belleville JP,Ward DS,Bloor BC,Maze M

    更新日期:1992-12-01 00:00:00

  • Predictors of pulse oximetry data failure.

    abstract:BACKGROUND:Pulse oximeters have been reported to fail to record data in 1.12-2.50% of cases in which anesthesia records were handwritten. There is reason to believe that these may be underestimates. Computerized anesthesia records may provide insight into the true incidence of pulse oximetry data failures and factors t...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199604000-00013

    authors: Reich DL,Timcenko A,Bodian CA,Kraidin J,Hofman J,DePerio M,Konstadt SN,Kurki T,Eisenkraft JB

    更新日期:1996-04-01 00:00:00

  • Metabolic changes during recovery in normothermic versus hypothermic patients undergoing surgery and receiving general anesthesia and epidural local anesthetic agents.

    abstract:BACKGROUND:Mild hypothermia is accompanied by metabolic changes. Epidural local anesthetic agents attenuate the surgical stress response, but it is not known whether they modulate thermal stress. METHODS:Thirty patients undergoing colorectal surgery, performed by one surgical team, received epidural 0.5% bupivacaine t...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199805000-00011

    authors: Motamed S,Klubien K,Edwardes M,Mazza L,Carli F

    更新日期:1998-05-01 00:00:00

  • Effects of fentanyl on peripheral and cerebral hemodynamics in neonatal lambs.

    abstract::The effects of fentanyl or cardiovascular function, regional distribution of cardiac output, and the dose required for producing anesthesia were studied in ten previously catheterized, newborn lambs. In addition, the effects of fentanyl on cerebral blood flow and oxygen utilization were examined. Fentanyl in cumulativ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198704000-00013

    authors: Yaster M,Koehler RC,Traystman RJ

    更新日期:1987-04-01 00:00:00

  • Pharmacokinetics, neuromuscular effects, and biodisposition of 3-desacetylvecuronium (Org 7268) in cats.

    abstract::The pharmacokinetics, biodisposition, and neuromuscular blocking properties of 3-desacetylvecuronium were studied in 17 adult cats. Animals were divided into three groups: five cats with kidney failure induced by bilateral ligation of the renal pedicles, six cats with galactosamine-induced fulminant hepatitis, and six...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199106000-00013

    authors: Segredo V,Shin YS,Sharma ML,Gruenke LD,Caldwell JE,Khuenl-Brady KS,Agoston S,Miller RD

    更新日期:1991-06-01 00:00:00

  • The effect of isoflurane-induced hypotension on cerebral blood flow and cerebral metabolic rate for oxygen in humans.

    abstract::Deliberate hypotension was induced with isoflurane (mean inspired concentration 2.3 +/- 1.0%) in 12 patients undergoing craniotomy for clipping of cerebral aneurysms. Global cerebral blood flow (CBF) was measured before, during, and after hypotension. Arterio-venous O2 content difference was measured concomitantly, an...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198603000-00001

    authors: Newman B,Gelb AW,Lam AM

    更新日期:1986-03-01 00:00:00

  • Site of origin of halothane--epinephrine arrhythmia determined by direct and echocardiographic recordings.

    abstract::A constantly coupled bigeminal arrhythmia was induced in dogs anesthetized with thiopental-halothane by infusion of epinephrine (1 microgram.kg-1.min-1). The site of origin of the abnormal beat was localized to the interventricular septum by bipolar recordings from the left and right ventricular epicardium and two sit...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198208000-00006

    authors: Smith ER,Dresel PE

    更新日期:1982-08-01 00:00:00

  • Diagnostic value of histamine and tryptase concentrations in severe anaphylaxis with shock or cardiac arrest during anesthesia.

    abstract:BACKGROUND:The diagnosis of acute life-threatening allergic reactions during anesthesia relies on clinical signs, histamine and/or tryptase measurements, and allergic testing. In patients who die after the reaction, skin tests cannot be performed, and the effect of resuscitation manoeuvres on mediator concentrations is...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000276

    authors: Laroche D,Gomis P,Gallimidi E,Malinovsky JM,Mertes PM

    更新日期:2014-08-01 00:00:00

  • Sevoflurane Exposure during the Critical Period Affects Synaptic Transmission and Mitochondrial Respiration but Not Long-term Behavior in Mice.

    abstract:BACKGROUND:Anesthesia during the synaptogenic period induces dendritic spine formation, which may affect neurodevelopment. The authors, therefore, evaluated whether changes in synaptic transmission after dendritic spine formation induced by sevoflurane were associated with long-term behavioral changes. The effects of s...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000001470

    authors: Chung W,Ryu MJ,Heo JY,Lee S,Yoon S,Park H,Park S,Kim Y,Kim YH,Yoon SH,Shin YS,Lee WH,Ju X,Kweon GR,Ko Y

    更新日期:2017-02-01 00:00:00

  • Myocardial hypercarbic acidosis reduces cardiac resuscitability.

    abstract:BACKGROUND:The severity of spontaneous myocardial hypercarbic acidosis during cardiac arrest previously has been predictive of the likelihood of restoring spontaneous circulation. The present study investigated whether hypercarbia itself impairs cardiac resuscitation. Since coronary perfusion pressure is the overriding...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199302000-00019

    authors: Maldonado FA,Weil MH,Tang W,Bisera J,Gazmuri RJ,Johnson B,D'Alessio A

    更新日期:1993-02-01 00:00:00

  • Intracarotid verapamil decreases both proximal and distal human cerebrovascular resistance.

    abstract:BACKGROUND:The authors determined the segmental effects of intracarotid verapamil in human subjects by using a novel method of measuring proximal and distal cerebrovascular resistance. Their hypothesis was that intracarotid verapamil, a calcium channel-blocking drug that augments cerebral blood flow and reverses arteri...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200404000-00005

    authors: Joshi S,Meyers PM,Pile-Spellman J,Wang M,Sahlein DH

    更新日期:2004-04-01 00:00:00

  • Isoflurane activates intestinal sphingosine kinase to protect against renal ischemia-reperfusion-induced liver and intestine injury.

    abstract:BACKGROUND:Renal ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury and often leads to multiorgan dysfunction and systemic inflammation. Volatile anesthetics have potent antiinflammatory effects. We aimed to determine whether the representative volatile anesthetic isoflurane protects against acut...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182070c3a

    authors: Kim M,Park SW,Kim M,D'Agati VD,Lee HT

    更新日期:2011-02-01 00:00:00

  • Dextrose affects gravitational spread of epidural anesthesia.

    abstract::Chloroprocaine, 0.5 per cent, with physiologic saline solution, has a specific gravity of 1.007 and a osmolarity of 283 mOsm/l, which increase to a specific gravity of 1.025 and an osmolarity of 542 mOsm/l when chloroprocaine is prepared in dextrose, 5 per cent. Chloroprocaine, 2.7 per cent, shows similar increases in...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198005000-00014

    authors: Park YR,Eastwood DW

    更新日期:1980-05-01 00:00:00

  • Transcutaneous cardiac pacing during thoracic surgery. Feasibility and hemodynamic evaluation by transesophageal echocardiography.

    abstract:BACKGROUND:Occasionally, emergency perioperative pacing is necessary. Transcutaneous cardiac pacing is noninvasive, safe, and readily available. Its feasibility and hemodynamic effects during thoracic surgery and one-lung ventilation have not been established. METHODS:Twenty anesthetized patients (aged 25-70 yr) witho...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-199310000-00013

    authors: Amar D,Gross JN,Burt M,Schwinger ME,Rusch VW,Reinsel RA

    更新日期:1993-10-01 00:00:00

  • Deep hypothermia and rewarming alters glutamate levels and glycogen content in cultured astrocytes.

    abstract:BACKGROUND:Deep hypothermia has been associated with an increased incidence of postoperative neurologic dysfunction after cardiac surgery in children. Recent studies suggest an excitotoxic mechanism involving overstimulation of glutamate receptors. Extracellular glutamate uptake occurs primarily by astrocytes. Astrocyt...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199912000-00030

    authors: Bissonnette B,Pellerin L,Ravussin P,Daven VB,Magistretti PJ

    更新日期:1999-12-01 00:00:00