Moghadam Morteza Jabbari, Ommi Davood, Mirkheshti Alireza, Shadnoush Mehdi, Dabbagh Ali
Anesthesiology Research Center, Department of Anesthesiology, Shahid Beheshti University of Medicine, Tehran, Iran.
J Res Med Sci. 2012 Aug;17(8):728-31.
Clonidine, an alpha-2 adrenergic agonist, increases the quality of perioperative sedation and analgesia with a few side effects. This study was designed to assess the effect of clonidine premedication on the anesthesics used for elective below knee surgeries in opium abusers and non-abusers.
In a randomized clinical trial, 160 patients were selected and assigned into four groups. Eighty patients among the opium abusers were divided randomly into clonidine and no clonidine groups, with 40 patients in each, and 80 among the non-abusers were again divided randomly into clonidine and no clonidine groups, with 40 patients in each group. All were anesthetized for elective orthopedic operation using the same predetermined method. The total administered dose of propofol and other variables were compared.
THE TOTAL PROPOFOL DOSE IN A DECREASING ORDER WAS AS FOLLOWS: Abuser patients receiving placebo (862 ± 351 mg), non-abuser patients receiving placebo (806 ± 348 mg), abuser patients receiving clonidine (472 ± 175 mg), and non-abuser patients receiving clonidine (448 ± 160 mg). Hence, a statistically significant difference was observed among the four study groups (P value for ANOVA = 0.0001).
Adding clonidine as a preoperative medication decreases the patient's anesthetic needs; this decrease was even more considerable on the anesthetic needs than the effect of opium abuse history on anesthetic dose.
可乐定是一种α-2肾上腺素能激动剂,能提高围手术期镇静和镇痛质量,且副作用较少。本研究旨在评估可乐定术前用药对鸦片成瘾者和非成瘾者择期膝下手术所用麻醉剂的影响。
在一项随机临床试验中,选取160例患者并分为四组。80例鸦片成瘾者随机分为可乐定组和非可乐定组,每组40例;80例非成瘾者也随机分为可乐定组和非可乐定组,每组40例。所有患者均采用相同的预定方法进行择期骨科手术麻醉。比较丙泊酚的总给药剂量及其他变量。
丙泊酚总剂量由高到低依次为:接受安慰剂的成瘾者患者(862±351mg)、接受安慰剂的非成瘾者患者(806±348mg)、接受可乐定的成瘾者患者(472±175mg)、接受可乐定的非成瘾者患者(448±160mg)。因此,四个研究组之间观察到有统计学意义的差异(方差分析P值=0.0001)。
术前加用可乐定可降低患者的麻醉需求;这种降低对麻醉需求的影响比鸦片成瘾史对麻醉剂量的影响更为显著。