Martínez-Quiroz ZI, Lugo-Goytia G, Martínez-Monter J, Esquivel-Rodríguez VM

Language: Spanish
References: 14
Page: 147-151
PDF size: 92.58 Kb.

ABSTRACT

Objective: To determine if pre-medication with clonidine improves the effectiveness and safety of total intravenous anesthesia (TIVA) with propofol-ketamine. Design: Randomized, double blind, clinical trial. Patients and methods: Fifty patients undergoing major abdominal surgery were enrolled. The study group was premedicated with clonidine 3 mg/kg po, and the control group with placebo, 90 minutes before surgery. TIVA consisted of intravenous propofol plus ketamine. Hemodynamic stability, propofol consumption, recovery times, and analgesic requirements were evaluated, as well as post-surgical adverse events. Results: The combination of propofol and low-dose ketamine was associated with hemodynamic stability, whereas clonidine pre-medication had no influence on hemodynamic stability. The total propofol consumption was lower in the study group than in the placebo group. There were no differences in the time to eye opening or the orientation time between the two groups. Sedation scores upon entry to the recovery room were higher in the study group. The time to discharge from recovery was not different between groups. During recovery, the study group presented a lower incidence of nausea and emesis, and lower analgesic requirements. Conclusions: The combination of propofol and low ketamine doses makes TIVA a safe and effective technique for major abdominal surgery in ASA I–II patients. Clonidine pre-medication helps to reduce nausea, emesis, and analgesic requirements without prolonging recovery from anesthesia.

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