Anesth Analg 2003;97:1251-1253
© 2003 International Anesthesia Research Society
CARDIOVASCULAR ANESTHESIA
Intrathecal Clonidine and Severe Hypotension After Cardiopulmonary Bypass
Ferenc Puskas, MD PhD,
Enrico M. Camporesi, MD,
Colleen E. O’Leary, MD,
Michael Hauser, MD, and
Fadi V. Nasrallah, MD
From the Department of Anesthesiology, SUNY Upstate Medical University, Syracuse, New York
Address correspondence and reprint requests to Ferenc Puskas, MD, PhD, Department of Anesthesiology, SUNY Upstate Medical University, 750 E. Adams Street, Room 2146, Syracuse, New York. Address email to fpuskas{at}twcny.rr.com
The use of intrathecal clonidine as an adjunct for the management of chronic pain, intra- and postoperative analgesia is gaining an increase in popularity. However, antinociceptive doses of intrathecal clonidine may produce pronounced hemodynamic side effects, including hypotension and bradycardia. In this report, we present a case of severe hypotension after cardiopulmonary bypass in a patient with intrathecal clonidine infusion. We postulate that the intrathecally administered alpha 2-agonist clonidine reduced our patient’s ability to tolerate the hemodynamic lability that is present during the separation from cardiopulmonary bypass by potentially inhibiting sympathetic nervous system activity, renin-angiotensin system, or vasopressin release.
The authors report a case of severe hypotension after cardiopulmonary bypass in a patient receiving intrathecal clonidine infusion for chronic neuropathic pain.
|
