Skip to main content
Download PDF

Oral clonidine premedication reduces induction dose and prolongs awakening time from propofol-nitrous oxide anesthesia

Canadian Journal of Anesthesia volume 46, pages 894–896 (1999)Cite this article

Abstract

Purpose

To evaluate whether oral clonidine premedication affects the induction dose of propofol and awakening time from epidural and propofol anesthesia.

Methods

Thirty-nine female patients (ASA I or II) were randomly allocated to receive 5 μg · kg−1 clonidine po or no clonidine 90 min before induction of anesthesia. After epidural anesthesia was achieved with lidocaine, general anesthesia was induced with continuous iv infusion of propofol at a rate of 50 mg · min−1 until loss of eyelash reflex and responses to verbal commands, which were judged by a blinded observer. After a laryngeal mask airway was inserted, anesthesia was maintained with N2O 67%, O2 33% and propofol adjusted to maintain hemodynamic stability. After completion of surgery, a blinded observer recorded the time from discontinuance of ropofol and N2O until the patient was awake and responsive (awakening time), and then, the laryngeal mask airway was removed.

Results

The induction dose of propofol in the clonidine group (1.4 ±0.3 mg) was less than that in the control group (1.9 ±0.4 mg, P < 0.05), while the awakening time of the clonidine group (470 ±145 sec) was longer than that of the control group (329 ±123 sec, P < 0.05).

Conclusion

Premedication with 5 μg · kg−1 clonidine po reduced the induction dose of propofol, but delayed emergence from propofol anesthesia.

Résumé

Objectif

Déterminer si la clonidine orale administrée comme prémédication affecte la dose d’induction de propofol et le temps de réveil lors d’une anesthésie péridurale combinée à une anesthésie générale au propofol.

Méthode

Trente-trois patientes (ASA I ou II) ont été réparties au hasard et ont reçu 5 μg · kg−1 de clonidine po, ou n’ont pas eu de clonidine, 90 min avant l’induction de l’anesthésie. L’anesthésie péridurale étant réalisée avec de la lidocaïne, l’anesthésie générale a été induite avec une perfusion iv continue de propofol selon un débit de 50 mg · min−1 jusqu’à la disparition du réflexe ciliaire et des réponses aux commandes verbales, jugée par un observateur impartial. L’anesthésie a été maintenue, après l’insertion d’un masque laryngé, avec N2O 67 %, O2 33 % et du propofol ajusté au maintien de la stabilité hémodynamique. À la fin de l’intervention, un observateur objectif a noté le temps écoulé depuis l’arrêt du propofol et de N2O jusqu’au moment où la patiente était éveillée et pouvait réagir (temps de réveil), puis, on a enlevé le masque laryngé.

Résultats

La dose d’induction de propofol dans le groupe clonidine (1,4 ±0,3 mg) a été plus faible que dans le groupe témoin (1,9 ±0,4 mg, P < 0,05), et le temps de réveil dans le groupe clonidine (470 ±145 sec) a été plus long que dans le groupe témoin (329 ±123 sec, P < 0,05).

Conclusion

La prémédication avec 5 μg · kg−1 de clonidine po a réduit la dose inductive de propofol, mais a retardé le réveil après l’anesthésie au propofol.

References

  1. Richards MJ, Skues MA, Jarvis AP, Prys-Roberts C. Total i.v. anaesthesia with propofol and alfentanil: dose requirements for propofol and the effect of premedication with clonidine. Br J Anaesth 1990; 65: 157–63.

    PubMed  Article  CAS  Google Scholar 

  2. Goyagi T, Nishikawa T. Oral clonidine premedication reduces the awakening concentration of isoflurane. Anesth Analg 1998; 86: 410–13.

    PubMed  Article  CAS  Google Scholar 

  3. Katoh T, Ikeda K. The effect of clonidine on sevoflurane requirements for anaesthesia and hypnosis. Anaesthesia 1997; 52: 377–81.

    PubMed  Article  CAS  Google Scholar 

  4. Bellaïche S, Bonnet F, Sperandio M, Lerouge P, Cannet G, Roujas F. Clonidine does not delay recovery from anaesthesia. Br J Anaesth 1991; 66: 353–7.

    PubMed  Article  Google Scholar 

  5. Guglielminotti J, Descraques C, Petitmaire S, Almenza L, Grenapin O, Mantz J. Effects of premedication on dose requirements for propofol: comparison of clonidine and hydroxyzine. Br J Anaesth 1998; 80: 733–6.

    PubMed  CAS  Google Scholar 

  6. Kodaka M, Okamoto Y, Kakoi H, et al. The effects of premedication on induction doses of propofol and hemodynamic responses during induction. Masui 1997; 46: 1347–53.

    PubMed  CAS  Google Scholar 

  7. Wright PMC, Carabine VA, McClune S, Orr DA, Moore J. Preanaesthetic medication with clonidine. Br J Anaesth 1990; 65: 628–32.

    PubMed  Article  CAS  Google Scholar 

  8. Nishina K, Mikawa K, Maekawa N, Takao Y, Obara H. Clonidine decreases the dose of thiamylal required to induce anesthesia in children. Anesth Analg 1994; 79: 766–8.

    PubMed  Article  CAS  Google Scholar 

  9. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and perioperative fentanyl. Br J Anaesth 1992; 68: 126–31.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesia, Akita University School of Medicine, Hondo 1-1-1, 010-8543, Akita-city, Japan

    Toru Goyagi, Makoto Tanaka & Toshiaki Nishikawa

Authors
  1. Toru Goyagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Makoto Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshiaki Nishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toru Goyagi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Goyagi, T., Tanaka, M. & Nishikawa, T. Oral clonidine premedication reduces induction dose and prolongs awakening time from propofol-nitrous oxide anesthesia. Can J Anesth 46, 894–896 (1999). https://doi.org/10.1007/BF03012982

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03012982

Keywords

  • Clonidine
  • Dexmedetomidine
  • Famotidine
  • Laryngeal Mask Airway
  • Blinded Observer