Use of clonidin in anesthesia during cardiac surgery

Abstract

Introduction: Aim of the study is to evaluate influence of clonidin during anesthesia in a cardiac surgery. Material and methods: Ninety six patients undergoing scheduled coronary artery by-pass grafting (CABG) surgery were divided in to two groups. Control group consists of 60 patients anesthetized in a common way during CABG surgery. Second group consists of 36 patients. Four mg/kg body weight of clonidin during introductory anesthesia was administered intravenously and further 1mg/kg/h infusion was carried during anesthesia. Results: Cumulative dose of fentanil during anesthesia in a control and second group was 18,13±4,75mg/kg and 14,15±6mg/kg, respectively (p<0,05); postoperative artificial lung ventilation time 9,6±7,5 and 9,2±5,5 hours, respectively (n.s.) and first postoperative day fluid balance 1587±1019 ml and 2324±1450ml (p<0,001), respectively. In a second group more often low doses of dopamine (5mg/kg/min) were used (27% and 15% in a control group). Conclusions: 1. Lower doses of fentanil can be used when clonidin is applied during anesthesia for CABG surgery. 2. Use of clonidin during anesthesia for CABG surgery does not change time of postoperative artificial lung ventilation. 3. Use of clonidin during anesthesia for CABG surgery increase requirement for higher positive fluid balance, administration of low doses of vasoactive substances and decrease incidence of perioperative myocardial infarction. INTRODUCTION Anesthesia in cardiac surgery is one of the most difficult field of anesthesiology. The most difficult patients, whose adaptive reserve of cardiovascular system is very poor, are met in this field. These patients have ischaemic heart disease and arterial hypertension often. All these factors increase the risk of anesthesia. So it is very important to choose medications thoroughly and save the compensatory mechanisms of cardiovascular system under conditions of surgical stress [1,4] . [...].