• Aloka Samantaray, Mangu Hanumantha Rao, and Abha Chandra.
• Department of Anaesthesiology & Critical Care, Sri Venkateswara Institute of Medical Sciences, SVIMS University, Tirupati, Andhra Pradesh, India.
• Indian J Anaesth. 2012 Jul 1;56(4):359-64.

BackgroundTreatment of acute post-thoracotomy pain is particularly important not only to keep the patient comfortable but also to minimize pulmonary complications.AimThis study was designed to test the effect of pre-induction administration of clonidine, given as a single intravenous dose, on post-operative pain scores and fentanyl consumption in patients after thoracic surgery.Setting And DesignTertiary referral centre. Prospective, randomised, double-blind, placebo-controlled trial.MethodsSixty patients were randomly allocated to receive clonidine (3 mcg/kg) or saline pre-operatively before induction of anaesthesia. The primary endpoint was pain on coughing (visual analogue scale (VAS) 0-100 mm) 120 min after surgery, time to first analgesic injection in the post-anaesthesia care unit (PACU) and 24-h fentanyl consumption.Statistical AnalysisFor between-group comparisons, t-test and U-test were used as appropriate after checking normality of distribution. The incidence of complications between the groups was compared by Fisher's exact test.ResultsThe post-operative VAS for the first 120 min and the fentanyl consumption at 24 h was significantly greater in the placebo group compared with the clonidine group (P<0.05). The sedation score was increased in the clonidine group during study drug infusion, but did not differ significantly on admission to the PACU.ConclusionsA single intravenous dose of clonidine (3 mcg/kg) given before induction of anaesthesia significantly reduced the post-operative VAS score in the initial period and fentanyl consumption during 24 h after thoracic surgery.

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