Purpose: To determine the effects of diazepam or clonidine on the quality o
f sedation with propofol during regional anesthesia.
Methods: In a prospective randomised, controlled, double-blinded study, 60
patients undergoing elective gynecological surgery were studied. They were
given premedication with 0.15-mg clonidine (Group-CL, n = 20), 5mg diazepam
(Group-DZ, n=20), or placebo (Group-P, n=20) eo. After spinal anesthesia w
as established, sedation was provided with propofol and controlled using a
five-point sedation score at 3, "eyes closed but rousable to command", and
4, "eyes closed but reusable to mild physical stimulation". During sedation
, blinded anesthesiologist recorded occurrence of complications. At two hou
rs after end of sedation, patients were asked if they had intraoperative dr
eam and memory.
Results: The loading dose, steady-state infusion rate, and overall mean inf
usion rate in Group-CL were 0.80 mg . kg(-1), 2.35 mg . kg(-1) and 2.89 mg
. kg(-1). hr(-1), compared with 0.97 mg . kg(-1), 3.13 mg . kg(-1). hr(-1)
and 3.59 mg . kg(-1). hr(-1) in Group-DZ, and 1.38 mg . kg(-1), 4.10 mg . k
g(-1). hr(-1) and 4.36 mg . kg(-1). hr(-1) in Group-FI respectively. Indice
s of both Group-CL (P <0.001) and Group-DZ (P <0.05) were smaller than thos
e of Group-P. Moreover, clonidine reduced the incidence of uncontrolled mov
ement (P <0.01), while diazepam reduced the incidence of intraoperative mem
ory and increased the incidence of dream (P <0.05). Premedication did not a
ffect the incidence of other complications.
Conclusion: Both premedicants reduced propofol requirements and exerted ben
eficial effects on the incidence of some complications during sedation with
propofol as an adjunct to regional anesthesia.