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Clonidine in Patients Undergoing Noncardiac Surgery

Devereaux, P.J ; Sessler, Daniel I ; Leslie, Kate ; Kurz, Andrea ; Mrkobrada, Marko ; Alonso-Coello, Pablo ; Villar, Juan Carlos ; Sigamani, Alben ; Biccard, Bruce M ; Meyhoff, Christian S ; Parlow, Joel L ; Guyatt, Gordon ; Robinson, Andrea ; Garg, Amit X ; Rodseth, Reitze N ; Botto, Fernando ; Lurati Buse, Giovanna ; Xavier, Denis ; Chan, Matthew T.V ; Tiboni, Maria ; Cook, Deborah ; Kumar, Priya A ; Forget, Patrice ; Malaga, German ; Fleischmann, Edith ; Amir, Mohammed ; Eikelboom, John ; Mizera, Richard ; Torres, David ; Wang, C.Y ; VanHelder, Tomas ; Paniagua, Pilar ; Berwanger, Otavio ; Srinathan, Sadeesh ; Graham, Michelle ; Pasin, Laura ; Le Manach, Yannick ; Gao, Peggy ; Pogue, Janice ; Whitlock, Richard ; Lamy, André ; Kearon, Clive ; Chow, Clara ; Pettit, Shirley ; Chrolavicius, Susan ; Yusuf, Salim

The New England journal of medicine, 2014-04, Vol.370 (16), p.1504-1513 [Periódico revisado por pares]

Waltham, MA: Massachusetts Medical Society

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Título:
Clonidine in Patients Undergoing Noncardiac Surgery
Autor: Devereaux, P.J ; Sessler, Daniel I ; Leslie, Kate ; Kurz, Andrea ; Mrkobrada, Marko ; Alonso-Coello, Pablo ; Villar, Juan Carlos ; Sigamani, Alben ; Biccard, Bruce M ; Meyhoff, Christian S ; Parlow, Joel L ; Guyatt, Gordon ; Robinson, Andrea ; Garg, Amit X ; Rodseth, Reitze N ; Botto, Fernando ; Lurati Buse, Giovanna ; Xavier, Denis ; Chan, Matthew T.V ; Tiboni, Maria ; Cook, Deborah ; Kumar, Priya A ; Forget, Patrice ; Malaga, German ; Fleischmann, Edith ; Amir, Mohammed ; Eikelboom, John ; Mizera, Richard ; Torres, David ; Wang, C.Y ; VanHelder, Tomas ; Paniagua, Pilar ; Berwanger, Otavio ; Srinathan, Sadeesh ; Graham, Michelle ; Pasin, Laura ; Le Manach, Yannick ; Gao, Peggy ; Pogue, Janice ; Whitlock, Richard ; Lamy, André ; Kearon, Clive ; Chow, Clara ; Pettit, Shirley ; Chrolavicius, Susan ; Yusuf, Salim
Assuntos: Adrenergic alpha-2 Receptor Agonists - adverse effects ; Adrenergic alpha-2 Receptor Agonists - therapeutic use ; Aged ; Arteriosclerosis ; Aspirin ; Biological and medical sciences ; Clonidine ; Clonidine - adverse effects ; Clonidine - therapeutic use ; Death ; Dosage and administration ; Drug dosages ; Drug therapy ; Female ; General aspects ; Health aspects ; Heart attacks ; Heart rate ; Humans ; Hypotension ; Hypotension - chemically induced ; Kaplan-Meier Estimate ; Male ; Medical research ; Medical sciences ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Infarction - prevention & control ; Patient outcomes ; Perioperative Care ; Postoperative Complications - chemically induced ; Postoperative Complications - prevention & control ; Prevention ; Surgery ; Surgical Procedures, Operative - mortality ; Sympathetic nervous system ; Treatment Failure ; United States
É parte de: The New England journal of medicine, 2014-04, Vol.370 (16), p.1504-1513
Descrição: In this trial, clonidine, an α2-adrenergic agonist, did not reduce the rate of death or MI among patients undergoing noncardiac surgery. Clonidine did increase the risk of perioperative hypotension, bradycardia, and nonfatal cardiac arrest. Myocardial infarction is the most common major vascular complication of surgery and is associated with substantial mortality. 1 During and after noncardiac surgery, there is marked activation of the sympathetic nervous system, which can lead to a mismatch between the supply of and demand for myocardial oxygen and to subsequent myocardial infarction. 2 – 4 We previously reported that perioperative administration of a high-dose, long-acting beta-blocker (initiated 2 to 4 hours before surgery and continued after surgery) reduced the risk of myocardial infarction but increased the risk of death, stroke, and clinically important hypotension. 5 Clonidine, an α 2 -adrenergic agonist, blunts central sympathetic . . .
Editor: Waltham, MA: Massachusetts Medical Society
Idioma: Inglês

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Clonidine in Patients Undergoing Noncardiac Surgery

Waltham, MA: Massachusetts Medical Society

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