Effects of oral clonidine premedication on hemodynamic status in bimaxillary orthognathic surgery: A double-blind randomized clinical trial

Mohammadi, Farnoosh; Marashi, Mojtaba; Tavakoli, Iman; Khakbaz, Oveis

doi:10.1016/j.jcms.2016.01.004

Cited by 18 publications

(33 citation statements)

References 17 publications

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“…Unfortunately only limited literatures analyzed the prevalence of PONV and related risk factors as well as the proper management specifically in orthognathic surgery field up to now ( 1 - 3 , 10 , 23 ). Hence, further studies are needed to develop effective protocols for preventing this common and unpleasant problem in maxillofacial patients with intermaxillary fixation.…”

Section: Discussionmentioning

confidence: 99%

“…PONV prevention for orthognathic surgical patients remains an under-investigated domain of clinical care to maximize patient safety and satisfaction ( 1 , 2 ). Maxillomandibular elastic tractions and intermaxillary wires following orthognathic surgery can magnify the anxiety, agitation and risk of aspiration associated with PONV, which may be life threatening event in maxillofacial patients ( 1 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

“…It has been reported to prevent the sympatho-adrenergic response to anesthesia, suppress cardiovascular response to laryngoscopy and reduce anesthetic and analgesic requirements ( 13 , 14 ). It also provides preoperative sedation, postoperative analgesia and perioperative hemodynamic stability ( 5 , 6 , 10 , 11 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, recent investigations have demonstrated that premedication with oral clonidine is successful in reducing the PONV after strabismus, ear and breast cancer surgeries as well as appendectomy and thyroid surgeries due to its multifactorial influence on decreasing stress, general sympathetic tone and catecholamine release ( 5 - 7 , 10 , 11 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Ondansetron versus Clonidine efficacy for prevention of postoperative pain, nausea and vomiting after orthognathic surgeries: A triple blind randomized controlled trial

Samieirad

Sharifian-Attar²,

Eshghpour³

et al. 2018

Med Oral

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BackgroundThe aim of this randomized controlled triple blind trial was to compare the efficacy of clonidine with dexamethasone versus ondansetron with dexamethasone for postoperative pain, nausea and vomiting prevention in orthognathic surgery patients.Material and MethodsIn this clinical trial study, 30 consecutive patients with skeletal class III deformities were candidates for orthognathic surgery in Qaem hospital, Mashhad University of medical sciences, Mashhad, Iran from March to November 2017. These subjects were randomly assigned to two equal number groups, ondansetron or clonidine. Patients received either oral ondansetron 8mg or oral clonidine 150μg as premedication, 1 hour before the surgery (both dissolved in 20 cc of water). Also both groups received intravenous dexamethasone 8mg (1 hour preoperatively and every 4 hours intraoperatively).ResultsIn this study, a total of 30 patients (14 males and 16 females) with a mean age of 23.9 ± 3.9 were investigated. The incidence of postoperative nausea in women was more than men (p=0.003), also the correlation between the incidence of PON and the surgery duration ≥ 3 hours was statistically significant (p = 0.050). The frequency of postoperative nausea (PON) in the ondansetron group was less than clonidine (53.3% vs 73.3% respectively). There was no postoperative vomiting (POV) in the ondansetron group, but 6.7% of cases in clonidine group suffered POV. Post-operative nausea in ondansetron group occurred significantly later than clonidine (525.0±233.2 vs 100.0±34.0 min; p<0.001). On the other hand, the incidence time of post-operative severe pain or in other word the analgesia time in clonidine group was significantly more than ondansetron one (875/0±68/5 vs 614.3±159.1 min; p<0.001).ConclusionsOndansetron with dexamethasone premedication was more effective in controlling PONV after orthognathic surgery compared to clonidine with dexamethasone group. Key words:Postoperative nausea and vomiting, ondansetron, clonidine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Ondansetron versus Clonidine efficacy for prevention of postoperative pain, nausea and vomiting after orthognathic surgeries: A triple blind randomized controlled trial

Samieirad

Sharifian-Attar²,

Eshghpour³

et al. 2018

Med Oral

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“…Three other studies confirm oral clonidine's effect on hemodynamic status when used as a premedication in: bimaxillary orthognathic surgery, endoscopic sinus surgery, and nasal polyposis. In all three cases, the use of oral clonidine led to less surgical blood loss and shorter surgical time when clonidine was used rather than other premedication drugs (valium or placebo).…”

Section: Discussionmentioning

confidence: 99%

Clonidine as a preoperative sedative

Henry

Raybould

Romond³

et al. 2018

Special Care in Dentistry

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The purpose of this study was to -examine the use of oral clonidine as a preoperative sedative prior to parenteral moderate sedation. Initially, four patients were given 0.2 mg oral clonidine but reduced to 0.1 mg clonidine due to -significant drops in blood pressure. Oral clonidine doses of 0.1 mg were then given to 19 patients preoperatively. In all these patients, blood pressure measurements decreased, but there were no significant differences in amounts of sedative agents needed in the clonidine group and the control group (N = 80). The conclusions reached suggest that clonidine has an advantage over other preoperative sedation agents in anxious patients exhibiting hypertension and tachycardia. However, the preop ideal dose required to reduce the amount of sedative drugs used as well as provide anxiolysis remains unknown. In further studies, different doses should be explored to determine what dosage of clonidine may offer hemodynamic protection as well as decrease sedative drugs needed.

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