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Anesthesia and analgesia · Nov 2003
Case ReportsIntrathecal clonidine and severe hypotension after cardiopulmonary bypass.
- Ferenc Puskas, Enrico M Camporesi, Colleen E O'Leary, Michael Hauser, and Fadi V Nasrallah.
- Department of Anesthesiology, SUNY Upstate Medical University, Syracuse, New York, USA. fpuska@twcny.rr.com
- Anesth. Analg. 2003 Nov 1; 97 (5): 1251-3.
AbstractThe 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.
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