Journal of Nippon Medical School: Vol.67 No.6 page.429

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ArticleTitle The Effect of Oral Clonidine Premedication on Lumbar Cerebrospinal Fluid Pressure in Humans

AuthorList Koichi Maruyama, Shinhiro Takeda, Takashi Hongo, Noriyuki Kobayashi and Ryo Ogawa

Affiliation Department of Anesthesiology, Nippon Medical School

Language EN

Volume 67

Issue 6

Year 2000

Page 429-433

Received June 3, 2000

Accepted July 7, 2000

Keywords clonidine, lumbar cerebrospinal fluid pressure, cerebral perfusion pressure, cerebral blood flow

Abstract α-2 adrenergic agonists including clonidine decrease cerebral blood flow. The specific actions of clonidine on cerebrospinal fluid (CSF) pressure in humans remain to be elucidated. We evaluated the effect of oral clonidine premedication on lumbar CSF pressure in patients without intracranial disease. Seventy-four patients undergoing subarachnoidal block were divided randomly into either a clonidine or a control group. In the clonidine group, the patients were premedicated orally with 5μg/kg clonidine 60 min before arrival in the operating room. Subarachnoidal puncture was performed via midline approach using a 23-gauge needle at the L2-3 or L3-4 intervertebral space with the patient in the lateral decubitus position. Before the injection of local anesthetic, lumbar CSF pressure was measured. Lumbar CSF pressure was 8.1±2.4 mmHg in the clonidine group, which was significantly lower than that in the control group (9.4±2.8 mmHg, p<0.05). The cerebral perfusion pressures were 76.2±12.5 mmHg in the clonidine group and 91.7±15.4 mmHg in the control group (p<0.001). In the clonidine group, preanesthetic mean blood pressure had a significant correlation with lumbar CSF pressure (r=0.619, p=0.019). We conclude that Lumbar CSF pressure was attenuated by oral premedication with 5μg/kg clonidine. Clonidine also contributed to a significant correlation between preanesthetic mean blood pressure and CSF pressure.

Correspondence to Shinhiro Takeda, MD, PhD, Department of Anesthesiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
shin/anesth@nms.ac.jp

ArticleTitle	The Effect of Oral Clonidine Premedication on Lumbar Cerebrospinal Fluid Pressure in Humans
AuthorList	Koichi Maruyama, Shinhiro Takeda, Takashi Hongo, Noriyuki Kobayashi and Ryo Ogawa
Affiliation	Department of Anesthesiology, Nippon Medical School
Language	EN
Volume	67
Issue	6
Year	2000
Page	429-433
Received	June 3, 2000
Accepted	July 7, 2000
Keywords	clonidine, lumbar cerebrospinal fluid pressure, cerebral perfusion pressure, cerebral blood flow
Abstract	α-2 adrenergic agonists including clonidine decrease cerebral blood flow. The specific actions of clonidine on cerebrospinal fluid (CSF) pressure in humans remain to be elucidated. We evaluated the effect of oral clonidine premedication on lumbar CSF pressure in patients without intracranial disease. Seventy-four patients undergoing subarachnoidal block were divided randomly into either a clonidine or a control group. In the clonidine group, the patients were premedicated orally with 5μg/kg clonidine 60 min before arrival in the operating room. Subarachnoidal puncture was performed via midline approach using a 23-gauge needle at the L2-3 or L3-4 intervertebral space with the patient in the lateral decubitus position. Before the injection of local anesthetic, lumbar CSF pressure was measured. Lumbar CSF pressure was 8.1±2.4 mmHg in the clonidine group, which was significantly lower than that in the control group (9.4±2.8 mmHg, p<0.05). The cerebral perfusion pressures were 76.2±12.5 mmHg in the clonidine group and 91.7±15.4 mmHg in the control group (p<0.001). In the clonidine group, preanesthetic mean blood pressure had a significant correlation with lumbar CSF pressure (r=0.619, p=0.019). We conclude that Lumbar CSF pressure was attenuated by oral premedication with 5μg/kg clonidine. Clonidine also contributed to a significant correlation between preanesthetic mean blood pressure and CSF pressure.
Correspondence to	Shinhiro Takeda, MD, PhD, Department of Anesthesiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan shin/anesth@nms.ac.jp