Pini A, Clavario P, Pedevilla M, Airoldi G, Copello F, Massari D, Martinengo E, Trucco U, De Martini M
Cardiology Service, V. Buzzi Hospital, Milan, Italy.
J Cardiovasc Pharmacol. 1998 Dec;32(6):920-6. doi: 10.1097/00005344-199812000-00008.
Transdermal clonidine (TTSC) treatment was evaluated in 29 patients with mild to moderate hypertension scheduled for minor surgery. Two weeks before the scheduled operation, patients underwent 24-h ambulatory blood-pressure monitoring (ABPM) to evaluate the efficacy of previous oral antihypertensive treatment, which was then substituted with TTSC, 0.1 mg/day. After 1 week, the efficacy of TTSC was clinically assessed, and the dose increased to 0.2 mg/day if needed. ABPM was repeated 2 days before the scheduled operation and 2 days after surgery. The 24-h blood pressure (BP) and heart rate (HR) profiles were smoothed by Fourier analysis. Three patients withdrew for adverse events and one for inefficacy after dose adjustment, TTSC being effective in the remaining 25 patients. Two patients who completed treatment lacked postsurgical ABPM recording. In the 23 patients with all ABPM recordings, average 24-h BP and HR obtained preoperatively during TTSC treatment were slightly reduced compared with values recorded during previous oral therapy. BP changes after surgery were negligible, whereas HR showed a moderate increase. Minor adverse events occurred in four (14%) of 29 patients. Our results demonstrate that TTSC provides adequate BP control in patients with mild to moderate hypertension undergoing minor surgery.
对29例计划接受小手术的轻至中度高血压患者进行了透皮可乐定（TTSC）治疗评估。在预定手术前两周，患者接受24小时动态血压监测（ABPM）以评估先前口服抗高血压治疗的疗效，然后用TTSC替代，剂量为0.1毫克/天。1周后，对TTSC的疗效进行临床评估，必要时将剂量增加至0.2毫克/天。在预定手术前2天和手术后2天重复进行ABPM。通过傅里叶分析对24小时血压（BP）和心率（HR）曲线进行平滑处理。3例患者因不良事件退出，1例在剂量调整后因无效退出，TTSC在其余25例患者中有效。2例完成治疗的患者缺乏术后ABPM记录。在有所有ABPM记录的23例患者中，与先前口服治疗期间记录的值相比，TTSC治疗期间术前获得的平均24小时BP和HR略有降低。术后BP变化可忽略不计，而HR则有适度升高。29例患者中有4例（14%）发生轻微不良事件。我们的结果表明，TTSC可为接受小手术的轻至中度高血压患者提供充分的血压控制。
