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The Beta Blocker and Clonidine Protocol

Lesson 5
Clonidine

8. Clonidine: Yin et al.

Oral clonidine reduces myocardial ischemia in patients with coronary artery disease undergoing noncardiac surgery.
Yin YC, et. al.
Acta Anaesthesiol Sin. Dec;40(4):197-203 2002.

Yin et. al. found that Oral clonidine reduces myocardial ischemia in patients with coronary artery disease undergoing noncardiac surgery. Yin YC, et. al. Acta Anaesthesiol Sin. Dec;40(4):197-203 2002. Meta-analysis also has shown that clonidine can prevent perioperative cardiovascular complications. (Wijeysundera DN, Naik JS, Beattie WS: Alpha-2 adrenergic agonists to prevent perioperative cardiovascular complications: a meta-analysis. Am J Med 2003; 114: 742-52) and (Nishina K, Mikawa K, Uesugi T, Obara H, Maekawa M, Kamae I, Nishi N: Efficacy of clonidine for prevention of perioperative myocardial ischemia: a critical appraisal and meta-analysis of the literature. Anesthesiology 2002; 96: 323-9)

Yin et al., Acta Anaesthesiol Sin. Dec;40(4):197-203 2002.

bullet 60 ASA class III patients with coronary artery disease were allotted at random to two groups in a prospective, double-blind study to receive either clonidine (3 micrograms/kg) or placebo (control group) 90 minutes before arrival at the operating room
bullet Continuous Holter EKG monitoring
bullet The episode of myocardial ischemia defined as the magnitude of ST segment depression of at least 1 mm, occurring 60 ms after the J point and persisting for three minutes or more was recorded
bullet Premedication with oral clonidine significantly reduced the incidence of perioperative myocardial ischemia in patients with CAD undergoing noncardiac surgeries
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