MAUI, HAWAII Low-dose sublingual clonidine given before treatment helps calm anxious, tachycardic patients undergoing laser skin resurfacing and other cosmetic procedures, according to Dr. Roberta D. Sengelmann.
"I've been using clonidine for about 8 years, since I did my first face-lift. I use it for patients with blood pressures above 130/90 mm Hg. I check their blood pressure after 30 minutes. The clonidine has a bit of a calming, sedative effect. It really is quite effective," Dr. Sengelmann said at the annual Hawaii dermatology seminar sponsored by Skin Disease Education Foundation. The dose is small, just 0.1 mg of clonidine sublingually. A second dose may be required after about 15 minutes in a larger man.
Dr. Sengelmann, a dermatologic surgeon in Santa Barbara, Calif., added that she finds clonidine particularly useful in patients undergoing lengthier aesthetic procedures lasting 90 minutes or more. But she won't use the antihypertensive agent in patients with blood pressures below 110/6070 mm Hg, even if they're tachycardic and anxious. Instead she uses 10 mg of diazepam (Valium).
Dr. Christopher B. Zachary, session chair, said he has heard of periprocedural clonidine also being used in anxious Mohs surgery patients, adding that it strikes him as an intriguing way to minimize bleeding problems.
"In patients who are obviously a little anxiousmaybe they didn't sleep too well, maybe they were caught in busy trafficI can almost guarantee that if their blood pressure is up then they will have more bleeding problems," observed Dr. Zachary of the University of California, Irvine.
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