Clonidin in der Kinderanästhesie

D. Huber; F.-J. Kretz

doi:10.1055/s-2005-870158

AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie, Table of Contents

Anästhesiol Intensivmed Notfallmed Schmerzther 2005; 40(10): 567-575
DOI: 10.1055/s-2005-870158

Übersicht

Clonidin in der Kinderanästhesie

Efficacy of Clonidine in Paediatric AnaesthesiaD. Huber¹ , F.-J. Kretz²

¹ Zentrum Anästhesiologie, Medizinische Hochschule Hannover
² Klinik für Anästhesiologie und operative Intensivmedizin, Olgahospital, Pädiatrisches Zentrum des Klinikums Stuttgart

Abstract

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

Full Text

References

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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