[Clofelin in the regimen of intravenous anesthesia during surgery for severe burns]

The data on clofelin effect on the course of total anesthesia are contradictory. Clofelin effect on hemodynamics, drug doses, depth of anesthesia, and time of awakening after surgery was studied in 28 male patients with extensive deep thermal injuries in a state of acute burn toxemia and septicotoxemia. Randomized double blind study was carried out in 2 groups: study group, in which clofelin was injected intravenously (2.6 +/- 0.15 micrograms/kg) before induction to anesthesia and placebo group (0.9% NaCl, 20.0). Similar operations were carried out in both groups: debridement of burn wounds with autodermoplasty on body surface of different area. Methods of anesthesia were similar in both groups: premedication with reladorm at night and phenasepam before surgery; induction with phentanyl and thiopental and laryngeal mask installation; maintenance anesthesia with midasolam, thiopental, fentanyl, tracrium, and artificial ventilation of the lungs. The following parameters were recorded: hemodynamic (HR, ADsys, dia, mean); EEG (bispectral index--BIS, 95% right spectrum frequency--SEF-95). Drug consumption, volume of infusions, blood loss, and time of awakening were recorded. The authors failed to detect pronounced analgesic and sedative effects, which are assigned to clofelin, after its single use in the above mentioned dose, but noted its obvious stabilizing effect on hemodynamics, which persisted for up to 1.5 h after injection. Clofelin is recommended to be used in a dose of 2.5 micrograms/kg 10-15 min before induction in patients with burns with hyperdynamic circulation.