Diabetes attenuates the hemodynamic stabilizing effects of oral clonidine during off-pump coronary artery bypass surgery.
OBJECTIVE
To investigate the influence of diabetes mellitus on the hemodynamic-stabilizing effect of clonidine during off-pump coronary artery bypass (OPCAB) surgery.


METHODS
Prospective study.


METHODS
Public, university-affiliated hospital.


METHODS
40 patients (32 male, 8 female) scheduled for OPCAB surgery.


METHODS
Patients were divided into equal groups of diabetic and nondiabetic patients. All patients were given 150 microg oral clonidine 1 hour before induction. Anesthesia was induced and maintained with fentanyl, propofol, and sevoflurane. Propranolol was administered intermittently to maintain an adequate heart rate (HR; 50 to 70 bpm). Preoperative demographic data (fasting blood glucose concentration and hemoglobin A1c), dose of intraoperative drugs (propofol and propranolol), and outcome data (duration of intubation and duration of hospital stay after surgery) were analyzed.


RESULTS
In the diabetic and nondiabetic groups, the mean (+/-SD) plasma glucose values were 7.8 +/- 2.3 mmoL. L(-1) and 5.4 +/- 0.7 mmoL. L(-1), respectively (p < 0.05), and the mean (+/-SD) HbA1c values were 7.1 +/- 1.3% and 5.2 +/- 0.4%, respectively (p < 0.05). The mean propofol infusion rate was 2.8 +/- 0.9 mg. kg(-1). h(-1) in diabetic patients and 3.1 +/- 1.0 mg. kg(-1). h(-1) in nondiabetics (NS, p > 0.05). The total requirement for propranolol was 5.1 +/- 2.4 mg in diabetic patients and 1.6 +/- 1.1 mg in nondiabetics (p < 0.05).


CONCLUSIONS
Diabetes attenuates the hemodynamic stabilizing effects of preanesthetic oral clonidine in the clinical setting.
Kita
Takashi
T
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. tkita@cvn.bai.ne.jp
Mammoto
Tadanori
T
Taniguchi
Hiroshi
H
Yamasaki
Kyoko
K
Kishi
Yoshihoko
Y
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology*; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000368:Aged; D000758:Anesthesia; D001786:Blood Glucose / Q000378:metabolism; D003000:Clonidine / Q000494:pharmacology*; D001026:Coronary Artery Bypass; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011433:Propranolol / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D003000:Clonidine; D006442:Glycated Hemoglobin; D011433:Propranolol