Efficacy of Clonidine for Prevention of Perioperative Myocardial Ischemia

• Kahoru Nishina

  Instructor.

• Katsuya Mikawa

  Associate Professor.

• Takanobu Uesugi

  Research Associate.

• Hidefumi Obara

  Professor, Department of Anesthesia and Perioperative Medicine Faculty of Medical Sciences.

• Munetaka Maekawa

  Assistant Professor, Department of Hygiene.

• Isao Kamae

  Professor, Division of Health Informatics and Sciences Faculty of Medical Sciences, Kobe University Graduate School of Medicine.

• Nobuo Nishi

  Director, Takarazuka City Health Promotion Center, Takarazuka, Hyogo.

抄録

There is a belief that clonidine may be effective in reducing perioperative myocardial ischemic events, although the results of several trials are conflicting. The aim of the current study was to provide a systematic review of randomized controlled trials that tested the efficacy of clonidine in this regard. Data was collected from a MEDLINE search of English-language studies published from 1980 to 1999 and a manual search of bibliographies from retrieved articles. A total of 28 studies were assessed. According to the selection criteria (study design, population, intervention, and outcome) and a quality scoring system, seven studies were finally included in the meta-analysis. After homogeneity was established by Q value, the data were then combined using the fixed-effects model. The pooled odds ratio was calculated. A subgroup analysis based on the types of surgery and administration route was also performed to qualify the results. The results were expressed as odds ratio and 95% confidence interval. Heterogeneity of outcome data was negative in the trials. The pooled odds ratio was 0.49 (95% confidence interval 0.34-0.71). In the subgroup analysis, clonidine reduced the incidence of myocardial ischemia in patients undergoing cardiac and noncardiac surgery. Rates of bradycardia were similar in clonidine and placebo groups. The meta-analysis suggests that perioperative clonidine reduces cardiac ischemic episodes in patients with known, or at risk of, coronary arterial disease without increasing the incidence of bradycardia. Therefore, these findings strongly justify planning and execution of a definitive study seeking the benefits of clonidine.

収録刊行物

• Anesthesiology

  Anesthesiology 96 (2), 323-329, 2002-02-01

  Ovid Technologies (Wolters Kluwer Health)

キーワード

• Anesthesiology and Pain Medicine

詳細情報

• CRID: 1362825895533848832
• NII論文ID: 30009128016
• DOI: 10.1097/00000542-200202000-00016
• ISSN: 00033022
• Web Site: http://pubs.asahq.org/anesthesiology/article-pdf/96/2/323/334187/0000542-200202000-00016.pdf
• Web Site: http://journals.lww.com/00000542-200202000-00016
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