Reduced blood pressure lability during emergence from anaesthesia in rats: a pilot study using clonidine

In the post-operative setting, pressure lability is increased in hypertensive patients. alpha-2 agonists were shown qualitatively to reduce this lability qualitatively. Here, upon immobilization combined with emergence from anesthesia in rats and clonidine administration, pressure lability was quantitatively assessed and related to baroreflex sensitivity.

After local anesthesia of all incisions and surgical wounds and myorelaxation with metocurine, rats had halothane withdrawn for 60 min. Rats received (a) saline (n=8), (b) clonidine 30 microg/kg i.v (n=8) simultaneous to halothane discontinuation and (c) halothane readministration (n=8) 20 min after halothane discontinuation. Pressure lability was quantitatively assessed using occurrence/amplitude of peaks in systolic blood pressure (SBP) and cardiac baroreflex slope.

Clonidine was associated with partial blunting of hypertension, reduced standard deviation of SBP, reduced number and amplitude of peaks in systolic pressure. Clonidine was also associated with increased slope of the cardiac baroreflex upon early intervals of emergence, but not at later intervals.

Clonidine reduces pressure lability upon immobilization stress combined to emergence from anesthesia, via parasympathetic activation and possibly sympathetic inhibition during early emergence as opposed to sympathetic inhibition during late emergence.