What question did this study set out to answer?

To evaluate whether oral and transdermal administration of clonidine can effectively blunt perioperative sympathoadrenal activation and cardiovascular stress in patients undergoing major surgery.

July 1, 1997Critical Care Medicine

Effects of clonidine on prolonged postoperative sympathetic response

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Why the study?

Does perioperative clonidine reduce the postoperative sympathetic response in patients undergoing major upper abdominal surgery?

Key Points

To evaluate whether oral and transdermal administration of clonidine can effectively blunt perioperative sympathoadrenal activation and cardiovascular stress in patients undergoing major surgery.
Conducted a double-blind, placebo-controlled trial in 40 patients undergoing pancreatico-biliary or major upper abdominal surgery.
Patients received clonidine (0.2 mg orally plus a TTS-3 patch the evening before surgery and 0.3 mg orally on call to the operating room) or matched oral and transdermal placebos.
Hemodynamics, plasma catecholamines, clonidine, interleukin-6 concentrations, and 24-hour urinary cortisol and nitrogen excretion were assessed preoperatively and daily for 72 hours postoperatively.
Clonidine achieved therapeutic plasma concentrations (1.54 ± 0.07 µg/mL) and reduced preoperative epinephrine and norepinephrine levels by 65%.
Postoperative plasma catecholamine concentrations and the frequency rate of postoperative hypertension were markedly lower in the clonidine group across the 72-hour postoperative period.
Clonidine did not alter plasma interleukin-6, urinary cortisol, or urinary nitrogen excretion, and caused no observed adverse effects.

Structured PICO

Does perioperative clonidine reduce the postoperative sympathetic response in patients undergoing major upper abdominal surgery?

Population

40 patients scheduled for major upper abdominal (pancreatico-biliary) surgery

Intervention

Clonidine (0.2 mg orally and a clonidine TTS-3 patch the evening before surgery and 0.3 mg orally on call to the operating room)

Comparator

Matched oral and transdermal placebo

Outcome

Sympathoadrenal response measured by heart rate, systemic arterial blood pressure, plasma catecholamine, clonidine, interleukin-6 concentrations, and 24-hr urine cortisol and nitrogen excretion up to 72 hours postoperativelysurrogate

Perioperative oral and transdermal clonidine safely attenuates the catecholamine response to surgical stress and reduces postoperative hypertension.

Discussion

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Implication

Supports perioperative clonidine to blunt sympathetic response in major abdominal surgery; confirms RCT efficacy for catecholamine attenuation.

Cite This Study

Dorman et al. (1997) studied this question.

synapsesocial.com/papers/6a71fabde36a167817e398e5 https://doi.org/10.1097/00003246-199707000-00015

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Implication

Supports perioperative clonidine to blunt sympathetic response in major abdominal surgery; confirms RCT efficacy for catecholamine attenuation.

Effects of clonidine on prolonged postoperative sympathetic response

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Effects of clonidine on prolonged postoperative sympathetic response

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

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