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Background: Spinal fusion surgeries are often associated with major blood loss. The aim of this study was to investigate the effect of oral clonidine as premedication on the amount of blood loss and the need for blood transfusion during lumbar laminectomy spine surgery with pedicle screw insertion, achieved by controlled hypotension. Methods: In this double-blind randomized clinical trial, 100 patients scheduled for lumbar spine laminectomy with pedicle screw insertion (as a fusion procedure) were included. Patients were classified into two groups: The intervention group received a 0.2 mg clonidine tablet one hour before entering the operating room, and the control group received a placebo. The patients were compared with respect to hemodynamic variables, quality of the surgical field, duration of the surgery, estimated amount of blood loss, and any blood transfusion. Results: Oral clonidine was found to be significantly better in terms of maintaining stable dynamics and having a lower amount of blood loss, thereby requiring fewer blood transfusions compared to the control group. Conclusions: Premedication with 0.2 mg oral clonidine in patients undergoing lumbar spine laminectomy with pedicle screw insertion results in improved perioperative hemodynamic stability and a reduction in the amount of intraoperative blood loss, thereby reducing the need for blood transfusion. [ABSTRACT FROM AUTHOR]

Introduction: Hemodynamic disturbance is a common problem in patients undergoing thyroid surgery. It may be due to episodic increases in thyroid hormones (thyroid storm) or stimulation of the carotid sinus baroreflex. The aim of the present study was to investigate effectiveness of the pre-operative oral Clonidine on reducing these hemodynamic changes during total thyroidectomy surgery. Methods: In a prospective, randomized, double-blind study, 80 patients scheduled for elective total thyroidectomy were randomized to receive either 0.2 mg Clonidine (n=40) or a matched placebo (n=40) orally sixty minutes before entering the operating room. Hemodynamic variables, the duration of surgery, estimated amount of blood loss and the dose of administered remifentanil were recorded for further analysis. Results: Oral Clonidine was found to be significantly better in maintaining stable hemodynamics compared to the control group. Also, In the Clonidine group, the estimated amount of blood loss (110.4±10 ml vs. 182.2±11.4 mL, P =0.04), duration of the surgery (78.26±55.2 min vs. 105.16±61.75 min, P =0.027) and administered dose of remifentanil (26.67±6.6 μg vs. 216.2±14.8 μg, P =0.01) were also significantly lower than the control group. Conclusion: Pre-operative administration of 0.2 mg oral Clonidine in patients undergoing total thyroidectomy results in improved perioperative hemodynamic stability and reduced response to perioperative stress. [ABSTRACT FROM AUTHOR]