title: Oral clonidine pre-treatment and diazepam/meperidine sedation.
abstract: Clonidine has recently been used as a pre-operative medication and sedative/anxiolytic drug. Its extended duration of action makes it suitable for longer procedures. In this randomized, crossover, placebo-controlled clinical trial, we characterized the effects of oral clonidine pre-treatment on intravenous diazepam/meperidine sedation using the bi-spectral index (BIS) in 13 participants. Clonidine significantly increased the numbers of BIS-depressed readings and percent memory loss during sedation, while reducing total diazepam and post-operative analgesic dosages by 44% and 55%, respectively. Systolic, diastolic, and mean arterial blood pressures, as well as pulse rates, were reduced. Respiratory rate, oxygen saturation, end-tidal CO(2), and recovery from sedation were unchanged. Participants, surgeons, and sedationists preferred clonidine over the placebo. Clonidine pre-treatment increased and prolonged sedation and amnesia and stabilized vital signs while significantly decreasing diazepam and post-operative analgesic usage. These results suggest that pre-operative clonidine administration could be a useful supplement to intravenous sedation for dental procedures of long duration.
authors.affiliation: Section of Primary Care, The Ohio State University College of Dentistry, 305 W. 12th Avenue, Columbus, OH 43218-2357, USA. hall.611@osu.edu
authors.forename: D L
authors.initials: DL
authors.lastname: Hall
authors.forename: D N
authors.initials: DN
authors.lastname: Tatakis
authors.forename: J D
authors.initials: JD
authors.lastname: Walters
authors.forename: E
authors.initials: E
authors.lastname: Rezvan
mesh_terms: D000284:Administration, Oral; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000766:Anesthesia, Dental / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D003000:Clonidine / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods*; D018592:Cross-Over Studies; D003975:Diazepam / Q000008:administration & dosage; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D011229:Preanesthetic Medication; D012119:Respiration / Q000187:drug effects; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D000316:Adrenergic alpha-Agonists; D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D008614:Meperidine; D003000:Clonidine; D003975:Diazepam