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Case Reports
. 2003 Nov;97(5):1251-1253.
doi: 10.1213/01.ANE.0000083526.08033.20.

Intrathecal clonidine and severe hypotension after cardiopulmonary bypass

Ferenc Puskas  1 , Enrico M Camporesi, Colleen E O'Leary, Michael Hauser, Fadi V Nasrallah
Affiliations
Case Reports

Intrathecal clonidine and severe hypotension after cardiopulmonary bypass

Ferenc Puskas et al. Anesth Analg. 2003 Nov.

Abstract

The use of intrathecal clonidine as an adjunct for the management of chronic pain, intra- and postoperative analgesia is gaining an increase in popularity. However, antinociceptive doses of intrathecal clonidine may produce pronounced hemodynamic side effects, including hypotension and bradycardia. In this report, we present a case of severe hypotension after cardiopulmonary bypass in a patient with intrathecal clonidine infusion. We postulate that the intrathecally administered alpha 2-agonist clonidine reduced our patient's ability to tolerate the hemodynamic lability that is present during the separation from cardiopulmonary bypass by potentially inhibiting sympathetic nervous system activity, renin-angiotensin system, or vasopressin release. The authors report a case of severe hypotension after cardiopulmonary bypass in a patient receiving intrathecal clonidine infusion for chronic neuropathic pain.

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