Publication:

Comparative clinical study of the effect of oral clonidine premedication on intraoperative haemodynamics in the patients undergoing laparoscopic cholecystectomy

Background Pneumoperitoneum created during laparoscopy results in patho-physiologic changes, especially in the cardiovascular system. Clonidine diminishes stress response by reducing circulating catecholamines and hence increases perioperative circulatory stability in patients undergoing laparoscopic surgeries. This comparative clinical study was planned compare with controls the effects of oral clonidine premedication (150 micrograms) on the intraoperative haemodynamics during laparoscopic cholecystectomy.

Methods Sixty adult patients between 15-50 years, scheduled for laparoscopic cholecystectomy under general anaesthesia were enrolled in the study. The patients were randomly assigned to two study groups of 30 patients each, Group CL: received oral clonidine (150 microgram) 90 minutes before induction of anaesthesia and Group C: received placebo. Anaesthetic technique was same for both the study groups. Hemodynamic variables (Heart rate, systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and EtCO2 were recorded at specific times - baseline; 90 minutes following study drug administration; induction of anaesthesia; 5 and 10 minutes following intubation; At skin incision; after creation of CO2 pneumoperitoneum and every 15 minutes thereafter till end of surgery; after desufflation; 5 minutes following extubation.

Results Patients in clonidine group had lower HR, SBP and DBP values as compared to control group at all points of time after giving the study drug (P <0.05). Percent change from baseline in HR and Blood pressure at different points of time was significantly high in control group than in clonidine group.

Conclusions Oral clonidine premedication (150 micrograms) is safe and provides perioperative hemodynamic stability in ASA I and II patients undergoing laparoscopic cholecystectomy, and hence can be recommended as a routine premedication for laparoscopic procedures.