Clonidine Does Not Prevent Myocardial Ischemia During Noncardiac Surgery

Our study provides encouraging evidence that alpha-2 adrenergic agonists may reduce cardiac risk, especially during vascular surgery. Nonetheless, these data remain insufficient to make firm conclusions about their efficacy and safety. A large randomized trial of alpha-2 adrenergic agonists is therefore warranted. Additionally, future research must determine which specific alpha-2 adrenergic agonist should be used, and whether it is safe to combine them with other perioperative interventions (for example beta-adrenergic blockade).

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

Wijeysundera

Bender

Beattie

2009

Cochrane Database of Systematic Reviews

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

Duncan

Sankar

Beattie

et al. 2018

Cochrane Database of Systematic Reviews

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Our review concludes that prophylactic α-2 adrenergic agonists generally do not prevent perioperative death or major cardiac complications. For non-cardiac surgery, there is moderate-to-high quality evidence that these agents do not prevent death, myocardial infarction or stroke. Conversely, there is moderate quality evidence that these agents have important adverse effects, namely increased risks of hypotension and bradycardia. For cardiac surgery, there is moderate quality evidence that α-2 adrenergic agonists have no effect on the risk of mortality or myocardial infarction, and that they increase the risk of bradycardia. The quality of evidence was inadequate to draw conclusions regarding the effects of alpha-2 agonists on stroke or hypotension during cardiac surgery.

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Alpha2-adrenergic agonists in cardiovascular anesthesia

Flacke

1992

Journal of Cardiothoracic and Vascular Anesthesia

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Clonidine Does Not Prevent Myocardial Ischemia During Noncardiac Surgery

Cited by 8 publications

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

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

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

Alpha2-adrenergic agonists in cardiovascular anesthesia

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