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Author Topic: Clonidine  (Read 10387 times)

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Dr.Madhav

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Clonidine
« on: May 21, 2008, 09:53:17 PM »
Friends,
I would like to know the experiences of my colleagues who have used clonidine.
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jafo1964

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Re: Clonidine
« Reply #1 on: May 22, 2008, 01:02:43 AM »
Have done 2 studies with clonidine


STUDY 1
Oral clonidine (2 mcg/kg) pre-op night and 3 hrs before surgery as adjunct to intra-op hypotensive anaes in patients undergoing FESS surgery with balanced GA with Isoflurane at 1%.
Super good rate and BP control
Never needed intra-op esmolol or NTG
MAP between 60 to 70 mm Hg

Problems - delayed recovery due to deep sedation. Ramsay scale 4 or 5 / 6
2 cases needed overnight admission because yhey did not meet PADCS score discharge criteria.

We compared this with ATENOLOL 25 mg same dosage timing
equally good haemodynamics and good recovery

In fact as a routine if there is no CI for betablockers I use it as premedication for all patients needing intra-op hypotensive anaesthesia
Polderman's study supports it.
But there is recent work questioning routine beta blockade esp in old people.

STUDY 2

Low dose bupivacaine and clonidine for SAB for lower limb surgeries
We started with 150 mcg as adviced in literature. Ended up with severe hypotension. reduced to 75 mcg and finlly we are happy giving 1/4 cc which is 37.5 mcg.
apart from prolonging duration, it provides sedation and also decreases incidence of peri-operative shivering. Haemodynamics at this dose are stable
Don't know if it is merely intrathecal effect of clonidine or also systemic absoption and central effect on CNS as demonstrated by IT opioids.
We are thinking of looking at the effect of IV clonidine on analgesia produced by epidural anaesthetics + narcotics

FINAL WORD
Clonidine's deep sedation is quite scary in some patients
If you are planning to  start - go intitally with lower doses until you work out your comfort zone

regs

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sandiphari

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Re: Clonidine
« Reply #2 on: October 18, 2008, 12:33:23 AM »
I HAVE USED CLONIDINE IN SA ALONG WITH  BUPIVACAINE+CLONIDINE 30 MICROGRAM. GOOD BP CONTROL/ SEDATION/ PROLONG EFFECT AND NO NAUSEA WITH SUCH DOSAGES.
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yogenbhatt1

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Re: Clonidine
« Reply #3 on: October 22, 2008, 11:40:58 AM »
Good drug, no doubt, but will require good post op monitoring as it can give hypotension up to 8 hr post op specially if volume replacement is not good. Also if early mobilisation is there.
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amarkatira

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Re: Clonidine
« Reply #4 on: February 15, 2009, 05:02:35 AM »
we are using it with bupivacaine in spinal regularly now. started with 1/4th ml and now happy with 15 micrograms.
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anesfrog

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Re: Clonidine
« Reply #5 on: April 24, 2009, 01:22:08 PM »
Great addition to narcotics. Need to be careful in the young with strong vagal responses, but a little for the elderly at induction goes along way.
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bhavin.shah

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Re: Clonidine
« Reply #6 on: June 02, 2009, 06:31:52 PM »
hi, we are using clonidine in SA with bupivacaine regularly. very good results with extended duration of action and hemodynemic stability.
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kalpesh shah

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Re: Clonidine
« Reply #7 on: June 05, 2009, 12:27:12 AM »
Hi, bhavin
 what doses ur using in SA at ur hospiatal?
 have u  ancountered prolong hypotension which is generally refractory to fluids?

regards and welcome to gasbag.net!!!!!!!!!!
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bhavin.shah

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Re: Clonidine
« Reply #8 on: June 05, 2009, 09:32:48 PM »
   hi kalpesh,
             we usually use sensorcaine alone. if we are expecting long duration, then we add clonidine. we encounter hypotension most of the time when we were using 45 mcg(0.3 ml). hypotension remain for long time and it is usually refractory to fluid. now we are using 15-20 mcg and that gives good hemodynemic stability.   
    regards.
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dimple parekh

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Re: Clonidine
« Reply #9 on: July 18, 2009, 11:54:10 PM »
Friends,
I would like to know the experiences of my colleagues who have used clonidine.
have been usind oral clonidine 3mc/kg atleast 90 min prior .for past 9 yrs.good haemodynamic control.ofcouse with acceptable brady.after iv clonidine.77-100 mc of iv diluted drug given over 8-10 min.controlled p/bp on intubation n gas inflation 4 laproscopy.
spinal clonidine  30-40 good analgesia post opt.epidural 50 mc good results.
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hiren naik,bilimora

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Re: Clonidine
« Reply #10 on: July 30, 2009, 09:59:37 PM »
hello,good discussion for clonidine.now a days com.provide micro[insulin]syringe,i use for lapro gynec side excellent control for tachy&hypertension due to hypercarbia.though post op recovery late require vigilant staff as in private you are in hurry most of time.friends i want to know your experience of epidural.thanks.best luck toall gasbag partner.
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drbhojane

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discitis after spinal anaesthesia
« Reply #11 on: September 12, 2009, 02:58:48 PM »
55yr female  pt. known case of dm &ht have undergone vag.hystretomy under spinal anaesthesia.
After 1month pt.develop discitis. now pt. has gone to CPA . pl. guide me .is it possible to have discitis after spinal anaesthesia
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