The effect of clonidine on perioperative blood coagulation

Abstract Study Objective To evaluate the influence of perioperative stress protection by clonidine on blood coagulation. Design Prospective, randomized, double-blinded, placebo-controlled clinical trial. Setting University hospital. Patients 50 patients scheduled for elective gynecoabdominal surgery. Interventions and Measurements Patients were randomly assigned to control (placebo) or clonidine group (single intravenous clonidine dose; 4 μ g/kg −1 or 3 μ g/kg −1 for age >65 years). Three measurement time points were defined: before administration of placebo/clonidine and anesthesia induction, (t1; baseline measurement); after surgery, before emergence of anesthesia (t2); and at the first postoperative day, 24 hours after anesthesia induction (t3). Blood coagulation was analyzed at all time points measuring international normalized ratio, platelets, thrombin-antithrombin complex, von Willebrand factor, soluble thrombomodulin, d-dimers, plasminogen activator inhibitor 1, and Thrombelastograph analysis. Main Results In the postoperative period (t2, t3), hypercoagulability was present in all patients compared with baseline measurements (t1) but without differences between the control and clonidine group. Regarding hematologic, laboratory blood coagulation, and Thrombelastograph parameters, there was no statistically and clinically relevant difference throughout the study period between the 2 groups. No hemodynamic adverse events of clonidine were observed in the perioperative period. Until day of discharge, no thrombotic or thromboembolic events were reported in both groups. Conclusions Preoperative administration of a single dose of clonidine has no effect on perioperative blood coagulation.