Comparison of Haemodynamic Response among Patients Posted for Laparoscopic Cholecystectomy with or without Oral Clonidine as Premedication- A Prospective Comparative Study

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Alka Koshire
Priyanka Satyanaryan Kandikatla
Hemant Pawar

Abstract

Background: Laparoscopic cholecystectomy is one of the most commonly performed surgeries and has now being recognized as the gold standard for the treatment of cholelithiasis. It is known fact that laparoscopy has several advantages due to creation of pneumoperitoneum during the surgical procedure which is responsible for several deleterious haemodynamic and cardiorespiratory changes. Thus, our present study was designed tostudy of haemodynamic response to oral clonidine as pre medication in laparoscopic cholecystectomy. Methods: In this prospective comparative study, 128 patients between the age group of 18-60 years, belonging to ASA 1 and ASA 2 categories scheduled for elective laparoscopic cholecystectomy under general anaesthesia were categorized into 2 groups as Group C and Group NC with 64 patients in each group. Patients in Group C received premedication with oral clonidine 150μg 90 minutes prior to surgery and Group NC did not receive oral clonidine 150μg. The two groups were compared with respect to heart rate, systolic and diastolic blood pressure and post operative complications. Results: There was significant increase in all the haemodynamic variables in group C as compared to group NC where the variables remained close to baseline while the patients in Group C showed less post operative complications as compared to NC group. Conclusion: Oral premedication with clonidine helps in blunting the haemodynamic response to pneumoperitoneum and also has less post operative complications.

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How to Cite
Koshire, A. ., Kandikatla, P. S., & Pawar, H. . (2022). Comparison of Haemodynamic Response among Patients Posted for Laparoscopic Cholecystectomy with or without Oral Clonidine as Premedication- A Prospective Comparative Study. MVP Journal of Medical Sciences, 8(1), 54–59. https://doi.org/10.18311/mvpjms/2021/v8i1/260

References

  1. Vecchio R, Mac Fayden BV, Palazzo F. History of laparoscopic surgery. Panminerva Med. 2000; 42:87-90.
  2. Girish PJ. Anesthesia for laparoscopic surgery. Canadian journal of Anesthesia. 2002; 49(1): 45-49 https://doi.org/10.1007/BF03018135
  3. Cunningham AJ, Brull SJ. Laparoscopic cholecystectomy: Anaesthetic implications. Anesthesia Analgesia. 1993; 76:1120-33. https://doi.org/10.1213/00000539-19930500000035 PMid:8053989
  4. Milne editorial alpha 2 aginists and anesthesia. Can J Anesth. 1991; 38;7:809-813. https://doi.org/10.1007/BF03036952 PMid:1683817
  5. Suzanne O-W. Laparoscopic surgery- effects on circulatory and respiratory physiology: An overview. European Journal of Surgery. 2000 Nov; 166:4-11. https://doi.org/10.1080/110241500750009627 PMid:10688209
  6. Singh S, Arora K. Effect of oral clonidine premedication on perioperative haemodynamic response and post operative analgesic requirement for patients undergoing laparoscopic cholecystectomy. Indian J Anaesth. 2011 JanFeb: 55(1):26-30 https://doi.org/10.4103/0019-5049.76583 PMid:21431049 PMCid:PMC3057241
  7. Suug CS, Lin SH, Chan KH, Chang WK, Chow LH, Lee Ty. Effect of oral clonidinepremedication on perioperative haemodynamic response and post operativeanalgesic requirements for patoents undergoing laparoscopic cholecystolithotomy. Acta Anesthsiology Sin. 2000 Mar; 38(I):23-9
  8. Singhal SK, Kaur K, Arora P. Oral clonidine versus gabapentin as premedicant for obtunding hemodynamic response to laryngoscopy and tracheal intubation. Saudi J Anaesth. 2014; 8(2):172-177. https://doi.org/10.4103/1658354X.130692 PMid:24843327 PMCid:PMC4024671
  9. Kalra NK, Verma A, Agarwal A, Pandey HD. Comparative study of intravenously administered clonidine and magnesium sulfate on haemodynamic responses during laparoscopic cholecystectomy. J Anaesthesiol ClinPharmacol. 2011; 27:344-8. https://doi.org/10.4103/0970-9185.83679 PMid: 21897505 PMCid: PMC3161459.
  10. Chandrashekaraiah MM, Upadya M, Jayachandran SP, Wali M. Effects of clonidine premedication on haemodynamic changes during laproscopic cholecystectomy- A randomized control study. Applied Cardiopulmonary Pathophysiology. 2011; 15: 91-98.
  11. Nicolaou G, Chen AA, Johnston CE, Kenny GP, Bristrow GK, Giesbrecth GG. Clonidine produces a dose dependant increase in the sweating threshold and dose dependant decrease in vasoconstriction and shivering threshold. Canadian Journal of Anesthesia. 1997 Jun; 44(6):636-42. https://doi.org/10.1007/BF03015448 PMid:9187784