ORAL CLONIDINE VS ORAL DIAZEPAM AS PREMEDITATION: IOP AND HOMODYNAMIC STABILITY AFTER GENERAL ANESTHESIA AND INTUBATIONS
Abstract
Background. In this study, we evaluated the effects of oral clonidine & diazepam on IOP & homodynamic stability after General Anesthesia (GA) with scholine & intubation in ECCE & intraocular lens implantation.
Methods. In this study 109 patients with ASA 1 to 3 were randomly allocated to two groups. Oral clonidine (3 µg/kg) and oral diazepam (0.15 mg/kg) were administered to interventional (54 subjects) and control (55 subjects) groups respectively as premeditation. All of patients under GA has given scholine (1.5 mg/kg), sodium thiopentone (5 mg/kg) and fentanyl (2 µg/kg). Heart rate, systolic and diastolic blood pressure and MAP were recorded before and 2hr after premeditation, immediately after intubation and 5th and 10th minute after scholine. IOP before and 2hr after premeditation & 5th and 10th minute after scholine with schiotz tonometer were measured.
Findings. In two groups, mean of IOP in 5th & 10th minute after scholine as compared to before scholine demonstrated significant decrease, so reduction was more significant in experimental group. In two groups, mean of MAP, SBP and DBP after intubation as compared to before intubation and gradually decrease. In 5th & 10th minutes after scholine, MAP and SBP has more stability in experimental group. HR has more significant stability in experimental group. Conclusion. Clonidine is an imidazoline derivative and central alpha2 receptor stimulator absorbed almost completely after oral administration. Clonidine has antihypertensive, sedative and analgesic effect. It reduces IOP. Diazepam is a benzodiazepine that reduce BP, IOP and has sedative effect. Our results suggest that oral clonidine as compared to oral diazepam as premeditation is more appropriate for reduction of IOP and homodynamic stability for patients undergoing cataract surgery under GA.
Methods. In this study 109 patients with ASA 1 to 3 were randomly allocated to two groups. Oral clonidine (3 µg/kg) and oral diazepam (0.15 mg/kg) were administered to interventional (54 subjects) and control (55 subjects) groups respectively as premeditation. All of patients under GA has given scholine (1.5 mg/kg), sodium thiopentone (5 mg/kg) and fentanyl (2 µg/kg). Heart rate, systolic and diastolic blood pressure and MAP were recorded before and 2hr after premeditation, immediately after intubation and 5th and 10th minute after scholine. IOP before and 2hr after premeditation & 5th and 10th minute after scholine with schiotz tonometer were measured.
Findings. In two groups, mean of IOP in 5th & 10th minute after scholine as compared to before scholine demonstrated significant decrease, so reduction was more significant in experimental group. In two groups, mean of MAP, SBP and DBP after intubation as compared to before intubation and gradually decrease. In 5th & 10th minutes after scholine, MAP and SBP has more stability in experimental group. HR has more significant stability in experimental group. Conclusion. Clonidine is an imidazoline derivative and central alpha2 receptor stimulator absorbed almost completely after oral administration. Clonidine has antihypertensive, sedative and analgesic effect. It reduces IOP. Diazepam is a benzodiazepine that reduce BP, IOP and has sedative effect. Our results suggest that oral clonidine as compared to oral diazepam as premeditation is more appropriate for reduction of IOP and homodynamic stability for patients undergoing cataract surgery under GA.
Keywords
Diazepam, Intraocular Pressure, Clonidine, Homodynamic status, General Anesthesia