Related Experiment Video

Updated: Jul 7, 2026

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits
06:46

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits

Published on: February 28, 2025

Intravenous clonidine infusion in infants after cardiovascular surgery

Anja Pohl-Schickinger1, Julia Lemmer, Michael Hübler

  • 1Department of Neonatology, University Hospital Charité, Berlin, Germany. anja.pohl@charite.de

Paediatric Anaesthesia
|January 31, 2008
PubMed

Insights

Intravenous clonidine infusion in infants after cardiac surgery is feasible, maintaining hemodynamic stability and normal heart rhythm without adverse effects. This off-label use can help reduce withdrawal symptoms and allow for opioid discontinuation.

Area of Science:

  • Pediatric Cardiology
  • Pediatric Critical Care Medicine
  • Pharmacology

Background:

  • Infants undergoing cardiac surgery often require prolonged analgesia and sedation.
  • Withdrawal symptoms like CNS hyperactivation, hypertension, and tachycardia are common post-surgery.
  • Managing these symptoms is crucial for hemodynamic stability.

Purpose of the Study:

  • To investigate the hemodynamic profile and heart rhythm in infants receiving intravenous clonidine infusion.
  • To assess the safety and efficacy of clonidine for sedation and withdrawal symptom management post-cardiac surgery.
  • To evaluate the potential for opioid discontinuation during clonidine treatment.

Main Methods:

  • Single center retrospective review of 50 infants (0-24 months) undergoing cardiovascular surgery.
  • Clonidine infusion (0.18-3.6 microg.kg(-1).h(-1)) administered for sedation and withdrawal symptom reduction.
  • Analysis of hospital records for hemodynamic parameters, heart rhythm, and adverse effects.

Main Results:

  • Clonidine infusion normalized hemodynamic parameters, reducing heart rate and mean arterial pressure within 24 hours (P < 0.001).
  • No instances of hypotension requiring additional therapy or adverse effects on cardiac rhythm, including atrioventricular block, were observed.
  • Opioid medications (Midazolam, fentanyl) were successfully discontinued by day 4 of clonidine treatment.

Conclusions:

  • Intravenous clonidine infusion is a feasible off-label option for infants in the Pediatric Intensive Care Unit (PICU) post-cardiac surgery.
  • Clonidine effectively manages hemodynamic parameters and withdrawal symptoms without causing hemodynamic instability or cardiac rhythm issues.
  • This approach facilitates opioid weaning and supports overall patient recovery.
Abstract

More Related Videos

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery09:47

Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery

Published on: June 2, 2022

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema08:44

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema

Published on: September 1, 2016

Related Concept Videos

Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Drug Delivery: Parenteral Route01:29

Drug Delivery: Parenteral Route

The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...