The effect of pretreatment with clonidine on propofol consumption in opium abuser and non-abuser patients undergoing elective leg surgery

OBJECTIVE: Clonidine, an alpha-2 adrenergic agonist, increases the quality of perioperative sedation and analgesia with a few side effects. This study was designed to assess the effect of clonidine premedication on the anesthesics used for elective below knee surgeries in opium abusers and non-abusers. MATERIALS AND METHODS: In a randomized clinical trial, 160 patients were selected and assigned into four groups. Eighty patients among the opium abusers were divided randomly into clonidine and no clonidine groups, with 40 patients in each, and 80 among the non-abusers were again divided randomly into clonidine and no clonidine groups, with 40 patients in each group. All were anesthetized for elective orthopedic operation using the same predetermined method. The total administered dose of propofol and other variables were compared. RESULTS: The total propofol dose in a decreasing order was as follows: Abuser patients receiving placebo (862 ± 351 mg), non-abuser patients receiving placebo (806 ± 348 mg), abuser patients receiving clonidine (472 ± 175 mg), and non-abuser patients receiving clonidine (448 ± 160 mg). Hence, a statistically significant difference was observed among the four study groups (P value for ANOVA = 0.0001). CONCLUSION: Adding clonidine as a preoperative medication decreases the patient's anesthetic needs; this decrease was even more considerable on the anesthetic needs than the effect of opium abuse history on anesthetic dose.