Intensive Care Medicine

, Volume 16, Issue 4, pp 265–266

Clonidine as a sedative adjunct in intensive care

  • H. Böhrer
  • A. Bach
  • M. Layer
  • P. Werning
Case Reports

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 μg kg−1 min−1 (1.44 mg 70 kg−1 24h−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 μg 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.

Key words

Clonidine Sedation Side effects Intensive care 

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Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • H. Böhrer
    • 1
  • A. Bach
    • 1
  • M. Layer
    • 1
  • P. Werning
    • 1
  1. 1.Department of AnaesthesiaUniversity of HeidelbergHeidelbergFRG

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