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Oral clonidine blunts the hemodynamic responses to brief but not prolonged laryngoscopy.

Abstract：

STUDY OBJECTIVE:To determine whether a 300 micrograms dose of oral clonidine given 90 minutes prior to laryngoscopy and intubation provides hemodynamic protection from the stress of a brief (15-second) and/or a prolonged (45-second) laryngoscopy. DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:Inpatients and outpatients scheduled for general anesthesia with intubation at a university-affiliated medical center. PATIENTS:Forty patients who gave informed, written consent to receive either an oral placebo or clonidine 5 micrograms/kg (up to a maximum dose of 300 micrograms) 90 minutes prior to induction of anesthesia and to undergo either brief or prolonged laryngoscopy prior to intubation. INTERVENTIONS:The patients underwent a standardized induction sequence that included d-tubocurarine 3 mg, thiopental sodium 5 mg/kg, and succinylcholine 1.5 mg/kg. The four treatment groups (each n = 10) included (1) placebo with 15-second laryngoscopy, (2) placebo with 45-second laryngoscopy, (3) clonidine with 15-second laryngoscopy, and (4) clonidine with 45-second laryngoscopy. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were mechanically obtained and recorded at 1-minute intervals for 12 minutes. MEASUREMENTS AND MAIN RESULTS:There were no differences between groups in the premedication hemodynamic measurements. Within each group, maximal hemodynamic variables increased significantly over the corresponding baseline values for that group. In the 15-second, but not the 45-second, laryngoscopy, clonidine successfully blunted the maximum SBP and DBP obtained when compared with the corresponding control group. In both the 15- and 45-second clonidine groups, maximum HR was significantly lower than in the corresponding placebo groups. CONCLUSIONS:Oral clonidine, when used as a preoperative medication, affords hemodynamic protection to patients undergoing a 15-second laryngoscopy. However, the stress of a 45-second laryngoscopy may be too great or the 300 micrograms dose of clonidine too low to provide hemodynamic protection for patients in this group.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Laurito CE,Baughman VL,Becker GL,Cunningham F,Pygon BH,Citron GM

doi

10.1016/0952-8180(93)90089-w

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

54-7

issue

eissn

0952-8180

issn

1873-4529

pii

0952-8180(93)90089-W

journal_volume

pub_type

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Oral clonidine blunts the hemodynamic responses to brief but not prolonged laryngoscopy.