title: The clinical effect of small oral clonidine doses on perioperative outcomes in patients undergoing abdominal hysterectomy.
abstract: We assessed the effect of small clonidine doses on anxiolysis, analgesia, and hemodynamic stability in patients undergoing abdominal hysterectomy. A total of 61 patients, ASA status I-II, were randomly assigned to receive either oral clonidine 100 microg (n = 29) or placebo (n = 32) before surgery and 24 h after surgery. The use of clonidine resulted in anxiolysis and analgesia throughout the 72 h after surgery, although the subjects who received clonidine were sleepier than the control group for the first 6 h after surgery. The number needed to treat was 3 (95% confidence interval [CI], 1.72-9.42) to prevent intense anxiety in patients with moderate to intense postoperative pain, compared with 40 (95% CI, 18.79-99.68) in the absence of pain or with mild pain. In the treated patients, 68% had an average heart rate less than 70 bpm during surgery, compared with 21.40% in the placebo group (number needed to treat, 2; 95% CI, 1.29-2.80). The clonidine patients required small ropivacaine doses during the surgery but not less morphine by patient-controlled analgesia. A clinically relevant anxiolytic effect was found in patients who received oral clonidine in the perioperative period, and this suggests that clonidine might be a useful therapeutic alternative to other preoperative sedatives.
authors.affiliation: *Psychiatric Service, Hospital Materno Infantil Presidente Vargas; †Anesthesia Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; ‡Universidade Federal do Rio Grande do Sul; and §Pharmacology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Maria Paz Loayza
authors.initials: MPL
authors.lastname: Hidalgo
authors.forename: Jorge Alberto Szimanski
authors.initials: JAS
authors.lastname: Auzani
authors.forename: Leandro Carpenedo
authors.initials: LC
authors.lastname: Rumpel
authors.forename: Nívio Lemos
authors.initials: NL
authors.lastname: Moreira
authors.forename: Arthur Werneck Costa
authors.initials: AWC
authors.lastname: Cursino
authors.forename: Wolnei
authors.initials: W
authors.lastname: Caumo
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000494:pharmacology*; D014151:Anti-Anxiety Agents / Q000494:pharmacology*; D001007:Anxiety / Q000517:prevention & control; D001794:Blood Pressure / Q000187:drug effects; D003000:Clonidine / Q000494:pharmacology*; D004311:Double-Blind Method; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control
chemical_list: D000700:Analgesics; D014151:Anti-Anxiety Agents; D003000:Clonidine
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