Clonidine as a pre-anesthetic agent for flexible bronchoscopy

• Published in: Respiratory medicine Vol. 98; no. 8; pp. 746 - 751
• Main Authors: Padua, Adriana Inacio de, Castro, Margareth de, Schmidt, André, Neto, Joaquim Coutinho, Filho, João Terra, Martinez, José Antônio Baddini
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-08-2004; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Analgesics; Anesthesia; Biological and medical sciences; Blood Pressure - drug effects; Bronchoscopy - methods; Clonidine; Double-Blind Method; Female; Flexible bronchoscopy; Heart attacks; Heart Rate - drug effects; Humans; Hydrocortisone - blood; Male; Medical sciences; Middle Aged; Pain - prevention & control; Pneumology; Preanesthetic Medication - methods; Stress; Stress response; Sympatholytics; Stress response; Flexible bronchoscopy; Clonidine; Bronchoscopy; Response; Agent; Flexible; Anesthetic; Endoscopy; Stress; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2004.01.015

Several drugs have been employed for sedation during flexible fiberoptic bronchoscopy (FOB). Clonidine attenuates stress-induced sympathoadrenal responses and has sedative properties. We investigate the effects of clonidine pre-medication on hemodynamic and comfort parameters of patients submitted to FOB under airway topical anesthesia only. Patients received placebo (
n=22; men=16; median age=50.5 years) or intravenous clonidine (3
μg/kg;
n=20; men=15; median age=46.0 years) 15
min before FOB. Blood pressure (BP), heart rate (HR), plasma norepinephrine (nor) and cortisol levels were measured before, during, and 1
h after FOB. Comfort was assessed by the examiner and by the patients using a visual numerical scale (0–10). The placebo group showed significant increases in systolic BP, HR, and nor levels during FOB (SBP = 125
mmHg×145
mmHg; HR=74
bpm×85
bpm; nor = 316.2
pg/dl×483.1
pg/dl), whereas clonidine group did not display such changes. Clonidine group showed a lower frequency of cardiac arrhythmias than the placebo group during and after FOB (supraventricular = 39%×50%; ventricular=22%×40%). Levels of comfort were high and comparable in both groups. We concluded that although clonidine led to a somewhat better hemodynamic profile, it did not contribute to better comfort in this setting.