There is some evidence that clonidine administered in small doses for short periods of time prior to noncardiac surgery would be able to prevent cardiac events.This study randomized 10010 patients over 45 years in 135 centers in 23 countries to clonidine or placebo. The primary end point of the study was the rate of death from any cause and nonfatal myocardial infarction at 30 days.At 30 days, the rate of death or infarction observed was 7.3 % in the clonidine group and 6.8 % in the placebo group (p = 0.29). Hypotension or bradycardia clinically important,were more frequent in the clonidine group, hypotension was an independent predictor of infarction (HR 1.37 , P < 0.001).
Conclusion
Clonidine does not reduce the risk of death or myocardial infarction in the perioperative period and should not be administered in patients undergoing noncardiac surgery in order to prevent events.
Daniel I. Sessler
2014-03-31
Original title: A Large International Trial Assessing the Effects of Clonidine on Major Arterial Events in Patients Having Noncardiac Surgery (POISE-2).
