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Effects of intravenous and oral clonidine on hemodynamic and plasma-catecholamine response due to endotracheal intubation.

Abstract：

STUDY OBJECTIVE:To investigate the effects of intravenous (IV) versus oral clonidine on alterations of heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), and plasma-catecholamines due to endotracheal intubation. DESIGN:Randomized, double-blind, placebo-controlled study. SETTING:University hospital surgery operating room. PATIENTS:33 ASA physical status I patients were randomly assigned to either receive clonidine 3 micrograms/kg IV immediately prior to anesthesia induction, clonidine 4 micrograms/kg orally 90 minutes prior to anesthesia induction, or placebo. INTERVENTIONS:Insertion of a 14 G cannula in a large cubital vein for the determination of plasma-catecholamines using local anesthesia. Insertion of a radial artery catheter for measuring blood pressure (BP) using local anesthesia. Transthoracic echocardiography determined CO. MEASUREMENTS AND MAIN RESULTS:Heart rate, MAP, CO, and plasma-catecholamine concentrations were measured. Measurements were performed prior to induction, during intubation, and 10 minutes after intubation. During endotracheal intubation, MAP was significantly lower in the IV clonidine group compared with the placebo and the oral clonidine groups. Cardiac output was significantly lower in the IV clonidine group only. In contrast to the placebo group, norepinephrine plasma concentrations did not increase in either clonidine group. Significant alterations of epinephrine plasma concentrations due to intubation were not observed in either group. Hemodynamics after intubation were not impaired by clonidine treatment. CONCLUSIONS:In conclusion, IV clonidine reduced stress response to endotracheal intubation compared with placebo. Oral clonidine at the dose used was less effective in blunting hemodynamic stress response than IV clonidine.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Zalunardo MP,Zollinger A,Spahn DR,Seifert B,Radjaipour M,Gautschi K,Pasch T

doi

10.1016/S0952-8180(97)00239-0

subject

Has Abstract

pub_date

1997-03-01 00:00:00

pages

143-7

issue

2

eissn

0952-8180

issn

1873-4529

pii

S0952-8180(97)00239-0

journal_volume

9

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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