Small, Oral Dose of Clonidine Reduces the Incidence of Intraoperative Myocardial Ischemia in Patients Having Vascular Surgery

Abstract

A small oral dose of clonidine, given prophylactically, can reduce the incidence of perioperative myocardial ischemic episodes without affecting hemodynamic stability in patients with suspected or documented coronary artery disease.

2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

“…General The relationship between measures of resting LV systolic function (most commonly LVEF) and perioperative events has been evaluated in several studies of subjects before noncardiac surgery. 56,58,[146][147][148][149][150][151][152][153][154][155][156][157][158][159][160][161] These studies demonstrate an association between reduced LV systolic function and perioperative complications, particularly postoperative HF. The association is strongest in patients at high risk for death.…”

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

“…The first randomized trials using clonidine to prevent cardiovascular complications after noncardiac surgeries demonstrated a reduction in myocardial ischemia, but no reduction in clinical events or mortality 187,188 . On the other hand, a meta-analysis has demonstrated that alpha2-agonists reduced mortality and acute myocardial infarction in patients undergoing vascular surgeries, but not in those undergoing nonvascular surgeries 189 .…”

Protocol implementation in anesthesia: beta-blockade in non-cardiac surgery patients

“…Recent reports have described the prevention of PMI/I using ABDs 6-10 and other therapeutic modalities. [11][12][13][14] Although 76% of PMI/I patients had documented risk factors, only 29% had received ABDs.…”