Visalia, CA 93291 805 West Acequia, Suite 1A
free consultation 800 804 5476

Bradycardia Reported After Clonidine Administration

AMERICAN JOURNAL OF COSMETIC SURGERY
JULY 9, 2002

Effects of Clonidine and Propofol-based Anesthesia
By Ed Lach, John Rachel and Ona Patrascyu

We used clonidine .1 mg P.O. with propofol 400 to 1600 mg IV drip plus ketamine 50 mg IV at the start of the case, for approximately 500 cases of liposuction lasting ½ hour to 1½ hours. We thought it was a useful adjunct, but had three cases of severe bradycardia during this time period.

When evaluating the etiology, we decided that because clonidine has been reported to cause bradycardia, we would abandon using clonidine. Since that time we have performed about 600 cases without clonidine, and have had no bradycardia problems.

These episodes were to 40 beats per minute and lasted 30 to 45 minutes, and the patients were quite symptomatic. We considered transporting each of them. They occurred about one-half hour postoperatively, roughly an hour and a half after clonidine was administered.

It is my opinion that the anesthetist, particularly the non-anesthesiologist, should try at all costs to minimize the number of drugs given to the patient in order to avoid drug interactions.

Robert Yoho, M.D.

Dr. Robert Yoho
Pasadena, California

References

  1. Agrez, M., Hellew, A., and Barrie, P.: Benign symmetric lipomatosis. Aust NZ J Surg 1995;65:616-618.
  2. Enzi, G.: Multiple symmetric lipomatosis, an updated clinical report. Medicine 1984;63:56-64.
  3. Martin, D.S., Sharafuddin, M., Boozan, J., Sundaram, M., Archer, C., et al.: Multiple symmetric lipomatosis (Madelung's disease). Skeletal Radiol 1995;24:72-73.
  4. Ruzica, T., Vieluf, D., Landthaler, M., and Braun-Falco, O.: Benign symmetric lipomatosis Launois-Bensaude: Report of ten cases and review of the literature. J Am Acad Dermatol 1987;17:663-674.
  5. Stavropoulos, P., Zouboulis, C.C., Trautmann, C., and Orfanos, C.E.: Symmetric lipomatosis in female patients. Dermatology 1997;194:26-31.
  6. McKusick, V.A.: Mendelian Inheritance in Man. Baltimore: Johns Hopkins University, 1978, p. 242.
  7. Luscher, H.J., Prein, J., and Spiessi, B.: Lipomatosis of the neck (Madelung's neck). Ann Plast Surg 1986;16: 502-508.
  8. Katou, F., Shirai, N., Motegi, K., Satoh, R., and Satoh, S.: Symmetriclipomatosis of the tongue presenting as macroglossia: Report of two cases. J Craniomaxillofac Surg 1993;7:298-301.
  9. Green, M.L., Glueck, C.J., Fujimoto, W.Y., and Seegmiller, J.E.: Multiple symmetric lipomatosis with gout and hyperlipoproteinemia. Am J Med 1970;48:239-246.
  10. Enzi, G., Inelman, E.M., Baritussio, A., Dorigo, P., Prosdocimi, M., and Mazzoleni, F.: Multiple symmetric lipomatosis: A defect in adrenergically stimulated lipolysis. J Clin Invest 1977;60:1221-1229.
  11. Klopstock, T., Naumann, M., Schalke, B., Bischof, F., Seibel, P., et al.: Multiple symmetric lipomatosis: abnormalities in complex IV and multiple deletions in mitochondrial DNA. Neurology 1994;44:862-866.
  12. Selvaag, E., Schneider, M., Wereide, K., and Kviem, M.: Benign symmetric lipomatosis Launois-Bensaude successfully treated with extensive plastic surgery. Dermatol Surg 1998;24:379-380.
  13. Springer, H.A., and Whitehouse, J.S.: Launois-Bensaude adenolipomatosis. Plast Reconstr Surg 1972;50:291-294.
  14. Carlin, M.C., and Ratz, J.L.: Multiple symmetric lipomatosis: Treatment with liposuction. J Am Acad Dermatol 1988;18:359-362.
  15. Leung, N.W.Y., et al: Multiple symmetric lipomatosis (Launois-Bensaude syndrome): Effect of oral salbutamol. Clin Endocrinol 1987;7:601-606.