Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Postoperative Analgesic Requirement for Patients Undergoing Laparoscopic Cholecystectomy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Objectives: Clonidine is a centrally acting sympatholytic agent with antihypertensive activity. It blunts stress response, provides analgesia, sedation and augments effects of anesthesia. Hence it was hypothesized to be an ideal agent to prevent stress response associated with laparoscopic surgeries and provide post-operative analgesia. Patients and Methods: 120 adult patients of ASA physical status I and II scheduled to undergo elective laparoscopic cholecystectomy under general anesthesia were randomly allocated to receive oral clonidine (150 mcg) premedication (Group I, n=60) or placebo (Group II, n=60) 90 mins prior to induction. Intra-operatively they were managed by standard anesthetic agents. The two groups were compared in terms of hemodynamic parameters, sevoflurane concentrations at predetermined intervals during surgery, post-operative time to analgesic request and cumulative analgesic requirements. Results: Mean heart rate, blood pressure and sevoflurane concentration requirements at 1 and 5 mins after intubation, skin incision, start of pneumoperitoneum, 15 and 30 mins after pneumoperitoneum and 15 mins after release of pneumoperitoneum were significantly lower in clonidine group than in placebo group. Time to request of analgesic in clonidine group (150.72 ± 38.47) was significantly higher than that in placebo group(128 ± 28.5 minutes), (p= 0.0004). Total post-operative tramadol requirement in excess of 2 doses was only in 15% of patients in clonidine group vs 60% of patients in placebo group. Conclusions: Administration of oral clonidine premedication resulted in better hemodynamic stability and reduction of intra-operative anesthetic requirement and post-operative analgesia.
Authors and Affiliations
Gouranga Dutta, Soumedhik Dey, Shubhadeep Das, Nandini Das
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