The effect of oral clonidine premedication on blood loss in primary total hip arthroplasty: A randomized placebo-controlled trial

Background: Substantial blood loss is a major concern in primary total hip arthroplasty and thus various blood conservation techniques are used to reduce blood loss in this surgery. Clonidine is frequently used in anesthesia for its antihypertensive property, however, the efficacy of oral clonidine premedication in reducing bleeding in total hip arthroplasty is not clear.Objectives: This study aimed to evaluate the impact of a single oral dose of clonidine premedication on blood loss and transfusion needs in patients undergoing primary total hip arthroplasty with balanced general anesthesia.Methods: Sixty patients classified as American Society of Anesthesiologists physical status 1 and 2, aged between 18 and 75 years, were randomly assigned to either the clonidine group or the placebo group, with 30 patients in each group. In this study, 60 minutes prior to the surgery, patients in the clonidine group received oral clonidine 0.2 mg and the placebo group received the identical placebo tablet. Intraoperative blood loss, transfusion requirements, need for supplementary remifentanil and nitroglycerin infusion, hemodynamic parameters, postoperative transfusion needs and hemoglobin level were measured and compared between the two groups.Results: The results showed that intraoperative blood loss, remifentanil usage, and the mean systolic and mean arterial blood pressures were significantly lower in the clonidine group compared with the placebo group. The postoperative hemoglobin value was significantly higher, and the reduction in the postoperative Hb level as well as the number of transfused patients were significantly less in the clonidine group.Conclusion: It can be concluded that 0.2 mg oral clonidine premedication significantly reduced intraoperative bleeding, and decreased postoperative changes in hemoglobin level and the number of transfused patients in primary total hip arthroplasty.