Comparison of Clonidine and Morphine for Premedication of Coronary Artery Bypass (CABG)

In order to reduce anxiety, establish sedation, analgesia, and maintenance of cardiovascular stability, preanesthetic medication, usually, Benzodiazepines and Anticholinergics are administered before CABG Clonidine, a α2 adrenoceptore agonist, produces sedation, somnolence, anxiolysis and analgesic effects by influence on central adrenergic cardiovascular neurons. Prolongation of respiratory support and time to extubation are associated with applying long acting opioids. Therefore, we compared Clonidine, Lorazepam with Morphine, Lorazepam in terms of duration of respiratory support and time of extubation. This double blind randomized clinical trial study was done on two groups consisting of 20 candidates of elective CABG . Group A received Morphine sulfate 0 . 1 mg / kg IM + Lorazepam 1 mg p . o and Group B received Clonidine 0 . 2 mg p.o. + Lorazepam 1 mg p.o. At the time of arrival on the operating table, the patients’ grade of sedation and consciousness, heart rate and mean arterial pressure were recorded . These parameters had no significant inter groups differences Two groups , were same as gender , weight and ASA class .Duration of respiratory support in ICU was 9.3 ± 2.4 hour for Group A and 7.6 ± 1.2 hour for Group B ( p < 0 . 05 ). Time of extubation in ICU was 10 . 06 ± 2.4 hour for Group A and 8.29 ± 1.21 hour for Group B(p < 0. 05 ) A significant difference was observed . so we concluded that Clonidine instead of Morphine as premedidication in elective CABG reduces duration of respiratory support and time of extubation, during providing stable hemodynamic and adequate sedation. Therefore Clonidine can be an appropriate alternative to Morphine in these patients .