[Clonidine in oral medicine. Literature review and our experience].
There is a large experience in premedication with clonidine (Catapresan) for general anaesthesia. Clonidine is an alpha2-adrenoceptor agonist exerting central sympatholytic effects. Premedication with clonidine blunts the stress response to surgical stimuli and the narcotic and anaesthetic dose can be reduced. Furthermore, perioperative myocardial ischemic events can be prevented by preoperative application of clonidine. Oral clonidine at a dose of 1.5-2 microg/kg BW combines the advantages of benzodiazepines and morphine: anxiolysis, sedation and analgesia with stable hemodynamics and respiration. Clonidine does not have morphine related side effects such as nausea and vomiting. Doses of up to 5 microg/kg BW have been administered to young and healthy patients preoperatively in dental and maxillofacial surgery without significant side effects. However, Clonidine 2 microg/kg BW should be an adequate oral premedication dose for young and healthy patients scheduled for dental and facial surgery procedures performed under local anaesthesia in the ambulatory setting. In elderly patients clonidine 2 microg/kg BW administered orally should not be exceeded to avoid excessive hypotension and sedation. Bradycardia is a contraindication for the use of clonidine.
Mutzbauer
Till S
TS
Klinik für Kiefer- und Gesichtschirurgie, Universitäts-Spital Zürich. till.mutzbauer@usz.ch
Obwegeser
Joachim A
JA
Grätz
Klaus W
KW
D000284:Administration, Oral; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local; D003000:Clonidine / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods; D006801:Humans; D017202:Myocardial Ischemia / Q000517:prevention & control; D019242:Oral Medicine / Q000379:methods; D019647:Oral Surgical Procedures / Q000379:methods*; D011229:Preanesthetic Medication
D000316:Adrenergic alpha-Agonists; D003000:Clonidine