Intravenous Clonidine for Perioperative Haemodynamic Stability during Laparo-Scopic Cholecystectomy – A One Year Randomised Controlled Study

Abstract

Background and Objectives ABSTRACT Haemodynamic instability has been reported in association with laparoscopic surgery in humans. Pneumoperitoneum and Laryngoscopy causes stress response with wide variations in haemodynamics. The present study was conducted to evaluate the effects of IV clonidine on reduction of perioperative stress response, maintaining hemodynamic stability, reduction of intraoperative anaesthetic requirement and on modulation of postoperative pain. Methods In the present prospective randomised controlled trial of forty patients aged between 18 to 60 years of ASA I and II undergoing laparoscopic cholesystectomy at KLES Dr. Prabhakar Kore Hospitals and Medical Research Centre, Belgaum were studied. Patients were divided into two groups of twenty each that is, Group I (Normal saline) and Group II (Clonidine 6 mcg/kg in normal saline). The study drugs were prepared by anaesthesiologist not involved in the study. Results Sex, age and weight and were comparable in both the groups. Study results clearly showed intraoperative MAP and HR changes were significantly at the lower level in clonidine group (p<0.05) at all intervals of procedure and also at laryngoscopy with consumption of isoflurane 0.2 -0.4% compared to control group at all intervals with consumption of isoflurane [1 - 1.5%]. VAS scores were IX significantly lower in clonidine group 24 hour postoperatively and requirement of first postoperative analgesic was prolonged up to 8 hour postoperatively. Conclusion and interpretation Clonidine given as 6 mcg/kg IV in two stages that is, at pre-induction and just before PNO maintains HR during PNO but one should be watch full for bradycardia. The mean arterial blood pressure was maintained with clonidine as it gives more haemodynamic stability, reduces intraoperative anaesthetic requirement and VAS scores and prolongs the requirement of first postoperative analgesic