What is clonidine used for in anaesthetics and intensive care?

Sedation on critical care

  • Sedation of intubated and mechanically ventilated patients as an adjunct to other sedatives
  • Treatment of agitated and delirious patients
  • Must be weaned gradually
IV infusion: 0.5-1.0 mcg/kg/hr
IV/PO: 50-200 mcg QDS

Adjunct to anaesthesia

  • Reduces MAC of volatile agents
IV: 1–2 mcg/kg

Adjunct to perioperative analgesia

IV: 1–2 mcg/kg

Adjunct to regional anaesthesia

  • Prolongs duration of effect
  • Useful in peripheral nerve, epidural, caudal and spinal blocks

Anxiolysis (Premedication)

  • May be a useful in both children and adults (though onset is slow)
PO: 4 mcg/kg

Antihypertensive

  • Medical use is limited by severe rebound hypertension following discontinuation
  • May be useful for hypotensive anaesthesia

Alcohol & opiate withdrawal

PO: 0.6-1.2 mg/day in divided doses

Postoperative shivering

IV/PO: up to 0.5 mcg/kg (low dose)

Migraine prophylaxis

PO: low dose