Recently there are articles of use of dexmedetomidine for CRBD. As clonidine belongs to same group as dexmedetomidine did it also have same effect? any study regarding the use of clonidine and CRBD?
Clonidine is known to decrease peak urethral pressure and facilitate bladder emptying in patients with neurogenic bladder. (I refer you to a paper on this by Rao et al. 1980. Euro Urol), but I'm not sure that that translates into any clinical efficacy for the purpose you mentioned of decreasing intra-vesicular catheter related pain or discomfort.
Indeed, animal models in male rats (Kontani et al. Jap J Pharmacology. 2000) demonstrates that clonidine and oxymetazoline both promote bladder hyperactivity by acting on alpha 2 adrenergic receptors.
Indeed, the agents most commonly used to used in treating IDC associated discomfort such as the anticholinergic Oxybutinin (ditropan) work by reducing bladder spasm and contraction. Thus, for those with an IDC in situ, there would be reason to assume that an agent such as clonidine which causes more unwanted bladder contraction whilst catheter is in situ may even exacerbate IDC discomfort.
Thank you Richard for the answer.In our study we have found that incidence of CRBD is reduced with use of preoperative clonidine. The exact mechanism is not certain.As per your explanation it should be increased.Whether central pain modulation or some other local effect is responsible needs to be ascertain
Hi yes.
I think you are right. Although clonidine might have a modest effect of increasing bladder contractions (something that one might expect would exacerbate bladder catheter discomfort), we also know that it has centrally acting analgesic properties.
Indeed, many of the studies that demonstrate this are, like yours, achieved with peri-operative clonidine. I've attached a link to just one of the studies regarding intravenous peri-operative clonidine on post laminectomy pain.
It may well be that this central analgesic effect rather than any modest impact on increased bladder contraction, that is mediating the efficacy you are demonstrating.
https://www.ncbi.nlm.gov/pubmed/17019247
Sorry Sanjay.
This is the correct link for the review article from Current Opinion in Anaesthesiology by Tryba et al. (2002)
https://www.ncbi.nlm.nih.gov/pubmed/17019247
- Badges
- Science topic
- Similar topics
- Correction