We tested a hypothesis that clonidine in premedication suppresses adverse hemodynamic reactions during ketamine-diazepam-fentanyl anesthesia for burned patients. In every enrolled patient during repeated anesthetic procedures we alternated between premedication with and without clonidine. 20 patients were administered 0,150 mg clonidine in 100 mls of normal saline intravenously, 15 minutes prior to the start of the procedure (clonidine i.v.). 10 patients were administered 0,300 mg clonidine intramusculary 30 minutes prior to the start of the procedure (clonidine i.m.). In both groups we observed decreased incidence of hypertension a tachycardia during operation (p<0,01); perioperative episodes of respiratory depression and postoperative sedation were suppressed only in clonidine i.v. (p<0,05). On the contrary, postoperative sedation in clonidine i.m. was more pronounced in comparison to control group (p<0,01). In both groups we observed a decrease in the ketamine dose (p<0,01) and diazepam dose (p<0,05). We did not observe a decrease in the incidence of psychomimetic reactions following ketamine administration. With respect to the adverse effects, we observed transitory hypotension prior to induction (clonidine i.m. 1x, clonidine i.v. 4x) and mild postoperative sedation in most patients from the group clo i.m. According to the adverse effects, the authors recommend administration of clonidine 0,150 mg intravenously as a standard premedication prior to ketamine-diazepam-fentanyl anesthesia.

        Key words: anesthesia for burn patients – clonidine – premedication – ketamine – diazepam – adverse effects – anesthetic consumption