Korean J Anesthesiol.  2003 Jun;44(6):777-784. 10.4097/kjae.2003.44.6.777.

Effect of Clonidine Supplementation on Jugular Bulb Oxygen Saturation and Carbon Dioxide Reactivity during Desflurane Anesthesia

• In JY
• Lee YS
• Yon JH
• Hong KH

• KMID: 2239952
• DOI: http://doi.org/10.4097/kjae.2003.44.6.777

Abstract

BACKGROUND: The alpha2-agonist clonidine is an adjunct in general anesthesia. Clonidine constricts cerebral arteries and decreases cerebral blood flow (CBF), but does not alter cerebral metabolic rate (CMR). Thus cerebral ischemia is possible due to CBF/CMR imbalance. This study was designed to prove the effects of clonidine bolus up on CBF and CO2 reactivity in desflurane anesthesia.
METHODS
Thirty patients were divided into a clonidine group (n = 15) and a control group (n = 15). Anesthesia was induced with thiopental and pancuronium, and maintained with 50% N2O/O2/ Desflurane. The jugular bulb was cannulated to measure jugular bulb oxygen saturation (SjO2). MAP and SjO2 were measured after induction, after clonidine (2 microgram/kg) or normal saline administration and during hyperventilation.
RESULTS
After clonidine administration, MAP decreased from 95.7+/-9.8 mmHg to 81.1+/-6.3 mmHg and was 79.9+/-5.0 mmHg during hyperventilation. In the control group, the corresponding MAP values 95.7+/-9.8 mmHg, 81.1+/-6.3 mmHg and 79.9+/-5.0 mmHg. After clonidine administration, SjO2 was decreased from 84.7+/-3.7% to 81.1+/-5.2%, and was 71.5+/-8.4% during hyperventilation (P = 0.003, P = 0.000) and in control group, there were 95.7+/-9.8%, 81.1+/-6.3% and 79.9+/-5.0%, respectively. CO2 reactivity was expressed as a change of SjO2 per unit change of PaCO2, 1.15+/-1.19%/mmHg versus 1.43+/-0.98%/mmHg (P = 0.49).
CONCLUSIONS
During desflurane anesthesia, clonidine-induced constriction of the cerebral arteries was demonstrated but CO2 reactivity was well preserved.

Keyword

Cerebral blood flow; carbon dioxide reactivity; clonidine; desflurane; jugular bulb oxygen saturation

MeSH Terms

Anesthesia*
Anesthesia, General
Brain Ischemia
Carbon Dioxide*
Carbon*
Cerebral Arteries
Clonidine*
Constriction
Humans
Hyperventilation
Oxygen*
Pancuronium
Thiopental
Carbon
Carbon Dioxide
Clonidine
Oxygen
Pancuronium
Thiopental