title: Cardiac arrest in a child with cerebral palsy undergoing sevoflurane induction of anesthesia after preoperative clonidine.
abstract: Clonidine is a frequently administered alpha2-adrenergic agonist which can decrease heart rate and blood pressure. We present a case of a 5-year-old child with cerebral palsy and seizure disorder, receiving clonidine for restlessness, who presented for placement of a baclofen pump. Without the knowledge of the medical personnel, the patient's mother administered three doses of clonidine during the evening before and morning of surgery to reduce anxiety. During induction of anesthesia, the patient developed bradycardia and hypotension requiring cardiac resuscitation. There are no previous reports of clonidine-associated cardiac arrest in a child undergoing induction of anesthesia.
authors.affiliation: Division of Pediatric Anesthesiology, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio, USA. mark.goldfinger@uhhs.com
authors.forename: Mark M
authors.initials: MM
authors.lastname: Goldfinger
authors.forename: Paul A
authors.initials: PA
authors.lastname: Tripi
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D002547:Cerebral Palsy / Q000601:surgery*; D002675:Child, Preschool; D003000:Clonidine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D008738:Methyl Ethers; D011229:Preanesthetic Medication / Q000009:adverse effects; D000077149:Sevoflurane
chemical_list: D000316:Adrenergic alpha-Agonists; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D003000:Clonidine