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Anästhesiol Intensivmed Notfallmed Schmerzther 2005; 40(10): 567-575
DOI: 10.1055/s-2005-870158
DOI: 10.1055/s-2005-870158
Übersicht
© Georg Thieme Verlag KG Stuttgart · New YorkClonidin in der Kinderanästhesie
Efficacy of Clonidine in Paediatric AnaesthesiaFurther Information
Publication History
Publication Date:
03 April 2006 (online)
Zusammenfassung
Clonidin ist ein gemischter alpha-2/alpha-1-Adrenoceptor-Agonist. Er vermindert den Sympathikotonus bei gleichzeitiger Steigerung des Parasympathikotonus mit dem Ergebnis einer Verringerung des Blutdruckes und der Herzfrequenz. Clonidin wurde zuerst als Medikament zur Therapie des Bluthochdruckes Ende der 60er-Jahre zugelassen. Der sedierende Effekt wird über die Stimulation von alpha2-Rezeptoren im Locus coeruleus vermittelt. Die analgetische Wirkung wird durch eine postsynaptische Wirkung am alpha2-Rezeptor von Nervenzellen im Rückenmark und Gehirn verursacht. In der Erwachsenen- und Kinderanästhesie scheint die Behandlung mit Clonidin eine sichere und effektive Methode zur Prämedikation, zur intra- und postoperativen Schmerztherapie, zur Prophylaxe des postoperativen Shiverings und zur Analgosedierung auf Intensivstationen darzustellen.
In diesem Artikel sollen die möglichen Indikationen für den Einsatz von Clonidin in der Kinderanästhesie und Intensivmedizin dargestellt und kritisch diskutiert werden.
Abstract
Clonidine is a mixed alpha2-/alpha1- adrenoceptor agonist. It decreases sympathetic tone and increases parasympathetic tone, which results in a lowering of blood pressure and heart rate. It was introduced as an antihypertensive medication in the late sixties. Yet Clonidine also has a sedative effect due to alpha2-adrenoceptor stimulation in the locus coeruleus and antinociceptiv action caused through postjunctional noradrenergic pathways in the brainstem and spinal cord. This analgesic property of Clonidine has raised broad interest in its beneficial use in anaesthesiology. In adults and pediatric anaesthesia, clonidine can be safely and effectively used for premedication, intraoperative and postoperative analgesia, postoperative shivering, and for analgo-sedation in intensive care.
This article will consider possible indications of Clonidine in children’s anaesthesia and intensive care medicine.
Schlüsselwörter
Clonidin - Kinder - Anästhesiologie - Analgesie - Sedierung
Key words
Clonidine - pediatric - anesthesia - analgesia - sedation
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Dr. med. Dirk Huber
Zentrum Anästhesiologie, Medizinische Hochschule Hannover
Carl-Neuberg-Straße 1 · 30625 Hannover
Email: huber.dirk@mh-hannover.de