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Background and objective: Clonidine, which is used for induction of sympatholysis and prevention or treatment of alcohol withdrawal in anaesthesia and intensive care medicine, may have deleterious effects on intestinal mucosal perfusion. This study was designed to investigate the effects of clonidine on intestinal perfusion and oxygenation. Methods: Following ethical approval 17 anaesthetized, and acutely instrumented pigs were randomly assigned to two groups: eight animals received intravenous clonidine (2 μg kg - 1 bolus and 2 μg kg - 1 h - 1 ), nine animals served as a control group. Measurement points for systemic and regional haemodynamic and oxygenation parameters were 135 and 315 mi n after starting the clonidine application. Results: Clonidine elicited systemic haemodynamic changes (median [25-75th interquartile range]): heart rate (106 [91, 126] to 84 [71, 90] beats min - 1 ) cardiac output (147 [123, 193] to 90 [87, 107] mL min - 1 kg - 1 ) and mean arterial pressure (77 [72, 93] to 69 [61, 78] mmHg) decreased. Despite systemic haemodynamic changes, the superior mesenteric artery blood flow did not change in the clonidine group. The vascular resistance of the superior mesenteric artery decreased. The small intestinal oxygen supply, the mucosal and the serosal tissue oxygen partial pressure did not change. Conclusions: Systemic sympatholysis induced by intravenously applied clonidine in addition to basic intravenous anaesthesia elicited a decrease in cardiac output and mean arterial pressure. However, regional macrohaemodynamic perfusion was maintained and intestinal oxygenation did not change. Clonidine does not impair intestinal mucosal and serosal oxygenation under physiological conditions.

Fragestellung. In der vorliegenden Pilotstudie sollte untersucht werden, ob Urapidil zur Therapie von postanasthetischem Shivering nach Allgemeinanasthesie geeignet ist. Methodik. ASA-I- und ASA-II-Patienten wurden mit Zustimmung der Ethikkommission der Friedrich-Schiller-Universitut Jena und schriftlicher Einwilligung nach standardisierter Narkosefuhrung im Aufwachraum uberwacht. Bei Auftreten von kontinuierlichem Shivering uber einen Zeitraum von 5 min wurden randomisiert und doppelblind 25 mg Urapidil oder 5 ml Placebo (isotone NaCl-Losung) intravenos appliziert. Bei den Patienten, bei denen das Shivering nicht sistierte, wurde die Medikamentengabe nach 5 min wiederholt. Bei vollstandiger Unterdruckung des postanasthetischen Shiverings wurde die Therapie mit Urapidil oder Placebo als wirksam gewertet. Ergebnisse. Es wurden 20 Patienten nach Auftreten eines postanasthetischen Shiverings mit Urapidil oder Placebo behandelt. Bei 7 von 10 Patienten, die mit Urapidil, und 2 von 10 Patienten, die mit Placebo therapiert wurden, sistierte das postanasthetische Shivering vollstandig (p

Clonidine, which is used for induction of sympatholysis and prevention or treatment of alcohol withdrawal in anaesthesia and intensive care medicine, may have deleterious effects on intestinal mucosal perfusion. This study was designed to investigate the effects of clonidine on intestinal perfusion and oxygenation.Following ethical approval 17 anaesthetized, and acutely instrumented pigs were randomly assigned to two groups: eight animals received intravenous clonidine (2 microg kg(-1) bolus and 2 microg kg(-1) h(-1)), nine animals served as a control group. Measurement points for systemic and regional haemodynamic and oxygenation parameters were 135 and 315 min after starting the clonidine application.Clonidine elicited systemic haemodynamic changes (median [25-75th interquartile range]): heart rate (106 [91, 126] to 84 [71, 90] beats min(-1)) cardiac output (147 [123, 193] to 90 [87, 107] mL min(-1) kg(-1)) and mean arterial pressure (77 [72, 93] to 69 [61, 78] mmHg) decreased. Despite systemic haemodynamic changes, the superior mesenteric artery blood flow did not change in the clonidine group. The vascular resistance of the superior mesenteric artery decreased. The small intestinal oxygen supply, the mucosal and the serosal tissue oxygen partial pressure did not change.Systemic sympatholysis induced by intravenously applied clonidine in addition to basic intravenous anaesthesia elicited a decrease in cardiac output and mean arterial pressure. However, regional macrohaemodynamic perfusion was maintained and intestinal oxygenation did not change. Clonidine does not impair intestinal mucosal and serosal oxygenation under physiological conditions.

Postanaesthetic shivering is common during recovery from general anaesthesia. Therefore we studied whether urapidil suppresses postanaesthetic shivering.With written informed consent and approval of the local ethics committee, patients (ASA I-II) recovering from general anaesthesia were monitored for 1 h. Patients with continuous shivering for a period of 5 min were randomly treated either with 5 ml placebo (isotonic saline) or 25 mg urapidil in a double-blind trial. This treatment procedure was repeated if shivering did not stop. A complete suppression of shivering was appraised as a sufficient treatment.Shivering occurred in 20 of the patients studied and urapidil stopped shivering in 7 out of the 10 treated patients, whereas the placebo stopped shivering in only 2 out of 10 patients (P0.05).In a placebo controlled trial, it was demonstrated that postanaesthetic shivering can be successfully treated by urapidil in 70% of the patients.

Reduced intestinal perfusion is one major cause in the development of multiple organ failure. Furthermore, the harmful effects of PEEP on intestinal perfusion and oxygenation are well described and it has been demonstrated that volume therapy reduces these effects. But there is no evidence on how to guide volume therapy, or whether volume therapy alone restitutes intestinal perfusion and oxygenation at PEEP levels above 10 cmH2O. Therefore we explored the effects of PEEP in an animal model of ITBV-guided volume loading.