Alpha-2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery

Wijeysundera, Duminda N.; Bender, Jennifer S; Beattie, W. Scott

doi:10.1002/14651858.cd004126.pub2

Cited by 75 publications

(58 citation statements)

References 180 publications

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“…Moreover, the patients randomized to TEA received the cardioprotective drug, clonidine, through their epidural catheter. This cardioprotective drug 19 was not administered to the control patients. The withdrawal of ␤-blockers in all study patients and the selective use of clonidine in the patients randomized to TEA may explain the large benefit of TEA on supraventricular arrhythmias found in this trial.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of Thoracic Epidural Anesthesia versus General Anesthesia for Cardiac Surgery

et al. 2011

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Background: A combination of general anesthesia (GA) with thoracic epidural anesthesia (TEA) may have a beneficial effect on clinical outcomes after cardiac surgery. We have performed a meta-analysis to compare mortality and cardiac, respiratory, and neurologic complications in patients undergoing cardiac surgery with GA alone or a combination of GA with TEA. Methods: Randomized studies comparing outcomes in patients undergoing cardiac surgery with either GA alone or GA in combination with TEA were retrieved from PubMed, Science Citation index, EMBASE, CINHAL, and Central Cochrane Controlled Trial Register databases. Results: The search strategy yielded 1,390 studies; 28 studies that included 2,731 patients met the selection criteria. Compared with GA alone, the combined risk ratio for patients receiving GA with TEA was 0.81 (95% CI: 0.40 -1.64) for mortality, 0.80 (95% CI: 0.52-1.24) for myocardial infarction, and 0.59 (95% CI: 0.24 -1.46) for stroke. The risk ratios for the respiratory complications and su-

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of Thoracic Epidural Anesthesia versus General Anesthesia for Cardiac Surgery

et al. 2011

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“…There were no significant intraoperative adverse effects in patients who had received intravenous Clonidine in our study. 14 There was minimal bleeding from the surgical site and the field was clear for the surgeon to operate. This parameter was assessed in our study by the surgeon.…”

Section: Discussionmentioning

confidence: 98%

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Praveen¹,

R²

2016

jemds

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BACKGROUNDClonidine an ideal agent for hypotensive anaesthesia, also attenuates stress response to laryngoscopy, decreases requirement of inhalational anaesthetic agents, decreases postoperative analgesic requirements, prevents post-operative shivering. MATERIAL AND METHODS60 patients under 16-60 years age group posted for functional endoscopic sinus surgery (FESS) were randomly divided into 2 groups of 30 each. Placebo group (Group P) received 20 mL normal saline intravenously and Clonidine group (Group C) received 2.5 micrograms Clonidine per kilogram body weight in 20 mL saline intravenously 20 mins before surgery. Haemodynamic variability during surgery, intraoperative inhalational agent requirement and perioperative bleeding as assessed by surgeon, postoperative analgesic requirement and post-operative shivering were compared between two groups. RESULTSThere was statistically significant reduction in heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure in Group C compared to Group P. There was statistically significant decrease in requirement of Isoflurane, decreased bleeding from surgical site, decreased analgesic consumption and nil incidence of postoperative shivering in Group C compared to Group P. CONCLUSIONClonidine is an ideal agent for hypotensive anaesthesia as it has got other favourable effects along with controlled hypotension, as it was observed in this study.

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“…Therefore, it is suggested that more studies will be necessary to confirm its benefits and safety to use in conjunction with other perioperative interventions like ß-blockers. [26] Recently, a randomised, double-blind, multi-centre clinical trial with a sample of 10,010 patients from 135 hospitals distributed across 23 countries was performed, evaluating the effect of clonidine, placebo, and ASA status. The clonidine group received 200 µg orally 2 to 4 hours before the surgical procedure, and as a transdermal patch that released 200 µg/24 h of clonidine, which was replaced every 72 hours post-surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of clonidine on the target dose of propofol: bispectral index evaluation

2015

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Alpha-2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery

Cited by 75 publications

References 180 publications

Meta-analysis of Thoracic Epidural Anesthesia versus General Anesthesia for Cardiac Surgery

Meta-analysis of Thoracic Epidural Anesthesia versus General Anesthesia for Cardiac Surgery

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Effect of clonidine on the target dose of propofol: bispectral index evaluation

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