The Influences of Clonidine Premedication on the Bispectral Index and Hemodynamics during the Induction of Anesthesia and Endotracheal Intubation with Propofol

Abstract

BACKGROUND: The bispectral index (BIS) has been used as an indicator of a sedative state. In this study, we investigated the influence of intravenous clonidine 2 or 3 microgram/kg on the bispectral index and cardiovascular response to anesthetic induction. METHODS: The study design is prospective, randomized and double-blind. Ninety patients scheduled to undergo elective surgery under general anesthesia were divided into 3 groups. Each group received no premedication (group 1, n = 30), clonidine 2 microgram/kg (group 2, n = 30) and clonidine 3 microgram/kg (group 3, n = 30). The sedation and responsiveness scores of the Modified Observer's Assessment of Alertness/Sedation Scale (MOAAS/S) were measured before induction and the BIS, blood pressure, and heart rate were measured at before induction, after propofol injection, and after intubation. RESULTS: The BIS was significantly lower in groups 2 and 3 than in group 1 before anesthetic induction and intubation. Mean blood pressure was significantly lower in groups 2 and 3 than in group 1 before anesthetic induction, after propofol infusion and after intubation. Heart rate was also significantly lower in groups 2 and 3 than in group 1 after intubation. The sedation score and MOAAS/S were significantly lower in groups 2 and 3 than in group 1. CONCLUSIONS: Clonidine-premedicated patients appear to maintain stable hemodynamics during anesthetic induction and intubation. The bispectral index can be objectively used in clonidine-premedicated patients when evaluating the degree of sedation. [By kind permission, KoreaMed, Korean Association of Medical Journal Editors.]