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Anesth Analg 2008; 106:899-909
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181619685
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NEUROSURGICAL ANESTHESIOLOGY

The Effect of Clonidine Infusion on Distribution of Regional Cerebral Blood Flow in Volunteers

Vincent Bonhomme, MD, MSc*, Pierre Maquet, MD, PhD{dagger}{ddagger}, Christophe Phillips, PhD{dagger}, Alain Plenevaux, PhD{dagger}, Pol Hans, MD*, Andre Luxen, PhD{dagger}, Maurice Lamy, MD*, and Steven Laureys, MD, PhD{dagger}{ddagger}

From the *University Department of Anesthesia and Intensive Care Medicine, CHU de Liege and CHR de la Citadelle, and {dagger}Cyclotron Research Center, and {ddagger}Department of Neurology, University of Liege and CHU de Liege, Liege, Belgium.

Address correspondence and reprint requests to Vincent Bonhomme, MD, MSc, University Department of Anesthesia and Intensive Care Medicine, Bd du 12eme deLigne, 1, 4000 LIEGE, Belgium. Address e-mail to vincent.bonhomme{at}chu.ulg.ac.be.

Abstract

BACKGROUND: Through their action on the locus coeruleus, {alpha}2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this observational study was to map brain regions whose activity is modified by clonidine infusion so as to better understand its loci of action, especially in relation to sedation.

METHODS: Six ASA I–II right-handed volunteers were recruited. Electroencephalogram (EEG) was monitored continuously. After a baseline H215O activation scan, clonidine infusion was started at a rate ranging from 6 to 10 µg · kg–1 · h–1. A sequence of 11 similar scans was then performed at 8 min intervals. Plasma clonidine concentration was measured. Using statistical parametric mapping, we sought linear correlations between normalized regional cerebral blood flow (rCBF), an indicator of regional brain activity, and plasma clonidine concentration or spindle EEG activity.

RESULTS: Clonidine induced clinical sedation and EEG patterns (spindles) comparable to early stage nonrapid eye movement sleep. A significant negative linear correlation between clonidine concentration and rCBF or spindle activity was observed in the thalamus, prefrontal, orbital and parietal association cortex, posterior cingulate cortex, and precuneus.

CONCLUSIONS: The EEG patterns and decreases in rCBF of specific brain regions observed during clonidine-induced sedation are similar to those of early stage nonrapid eye movement sleep. Patterns of deactivated brain regions are also comparable to those observed during general anesthesia or vegetative state, reinforcing the hypothesis that alterations in the activity of a common network occur during these modified conscious states.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.