Comparison Of Dexmedetomidine And Clonidine Infusions On Haemodynamic Stability In Patients Undergoing Laparoscopic Cholecystectomy – A Double Blind Randomized Controlled Trial

Abstract

Background and Objectives Laparoscopic Cholecystectomy is a routinely performed surgery and it is desirable to have a stable intraoperative haemodynamic status by avoiding hypertension, hypotension or tachycardia. The present study has been conducted to compare the beneficial effect of the two alpha 2 agonists Clonidine and Dexmedetomidine in maintaining the perioperative haemodynamic parameters during laparoscopic cholecystectomy. Methods The present Double Blind Randomized Control Trial was conducted in the Department of Anaesthesiology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum attached to Jawaharlal Nehru Medical College, Belgaum during the period of Dec 2010 to June 2011. A total of 45 patients randomly allocated in three groups, Group I (Placebo Group), Group II (Clonidine Group) & Group III (Dexmedetomidine Group) of 15 patients each, undergoing elective laparoscopic cholecystectomy, under general anaesthesia were studied. The patients received preloaded and coded study drug as infusion (normal saline, Clonidine 4 mcg/kg/hr and Dexmedetomidine 0.4 mcg/kg/hr respectively) at the rate of 0.08 ml/kg/hr. Results Sex, age, weight and duration of surgery were comparable in all the three groups. Both the drugs, Clonidine and Dexmedetomidine, maintained cardiovascular stability during laparoscopic cholecystectomy. But Clonidine X appears more effective in maintaining perioperative cardiovascular system stability during laparoscopic cholecystectomy. In addition the isoflurane requirement in Clonidine Group and Dexmedetomidine Group was found to be considerably lower when compared to Placebo Group. Also, the mean recovery time as indicated by the ability to vocalize following extubation was found to be significantly less in Clonidine Group and Dexmedetomidine Group. Conclusion and interpretation Clonidine being more cost effective than Dexmedetomidine can be recommended for maintaining cardiovascular system stability during laparoscopic cholecystectomy.