Preoperative assessment: clonidine withdrawal: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Preoperative assessment: clonidine withdrawal

Sample item

A hypertensive patient takes oral clonidine regularly and is listed for elective surgery. What is the correct perioperative advice and its reason?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Continue it, including on the morning of surgery, because abrupt withdrawal can cause rebound hypertension

Stopping clonidine suddenly causes rebound sympathetic overactivity with hypertension, tachycardia and agitation. It is therefore continued through the perioperative period, and an alternative route is arranged if the patient cannot take oral drugs.

Option by option

  • A. Stop it 48 hours before surgery, because it causes unpredictable bradycardia at induction

    Clonidine can lower the heart rate, but this is managed, not avoided by stopping the drug for two days.

  • B. Stop it a week before surgery, because it prolongs the action of muscle relaxants

    Clonidine does not prolong neuromuscular blockade, and stopping it for a week would invite uncontrolled blood pressure.

  • C. Continue it, including on the morning of surgery, because abrupt withdrawal can cause rebound hypertension (correct)

    Correct. Sudden withdrawal releases sympathetic tone and produces rebound hypertension, so the drug is continued.

  • D. Omit it on the morning of surgery, because it blocks the response to vasopressors

    Clonidine does not block vasopressor responses in a way that justifies omission, and omission risks rebound.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Continue it, including on the morning of surgery, because abrupt withdrawal can cause rebound hypertension. Stopping clonidine suddenly causes rebound sympathetic overactivity with hypertension, tachycardia and agitation.

Why is "Stop it 48 hours before surgery, because it causes unpredictable brad…" not the answer?

Clonidine can lower the heart rate, but this is managed, not avoided by stopping the drug for two days.

Why is "Stop it a week before surgery, because it prolongs the action of musc…" not the answer?

Clonidine does not prolong neuromuscular blockade, and stopping it for a week would invite uncontrolled blood pressure.

Why is "Omit it on the morning of surgery, because it blocks the response to…" not the answer?

Clonidine does not block vasopressor responses in a way that justifies omission, and omission risks rebound.

What concept does this question test?

It tests Preoperative assessment: clonidine withdrawal in Anaesthesia. It is therefore continued through the perioperative period, and an alternative route is arranged if the patient cannot take oral drugs.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Preoperative assessment: clonidine withdrawal?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.