[Clonidine supplemented analgesia and sedation in prevention of postoperative delirium].
In an open prospective study we investigated the efficacy of the supplementation of analgosedation by clonidine. 40 patients with oesophagus malignancy and definite alcohol abuse were on respiration therapy postoperatively after having been treated with oesophago-gastro anastomoses. With regard to manifestation intensity and development of withdrawal symptoms we found that during basic medication with piritramid-diazepam continuously i.v. administered clonidine can eliminate haemodynamic and psychovegetative symptoms related to alcohol withdrawal. The clonidine group required less analgosedation. The measurement of the urinary catecholamine output showed a normalised endogenous output. As a finding of importance the gastrovolume was reduced, and the haemodynamically firm, stable and less sedated patients of the clonidine group required fewer days of respiration therapy. Hence, the hazard of aspiration pneumonia and insufficienty anastomosis was lower. Risk of bradycardia of high potential danger did not occur with a median daily dosage of 1.09 mg/d clonidine. We consider clonidine to be a potent supplement to analgosedation for the surgical patient who is at high risk of alcohol withdrawal.
Verner
L
L
Zentrum Anästhesiologie, Abt. 1, Medizinische Hochschule Hannover.
Hartmann
M
M
Seitz
W
W
D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000517:prevention & control*; D000768:Anesthesia, General; D001143:Arousal / Q000187:drug effects; D003000:Clonidine / Q000008:administration & dosage*; D003422:Critical Care; D003975:Diazepam / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010892:Pirinitramide / Q000008:administration & dosage; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies
D010892:Pirinitramide; D003000:Clonidine; D003975:Diazepam
Clonidinsupplementierte Analgosedierung zur postoperativen Delirprophylaxe.