Effect of oral clonidine as premedication on hemodynamic changes during laparoscopic cholecystectomy
Journal Title: International Journal of Medical Science and Public Health - Year 2017, Vol 6, Issue 4
Abstract
Background: Pneumoperitoneum created during laparoscopy affects several homeostatic systems leading to alteration in cardiovascular, pulmonary physiology, and stress response. Clonidine, α2 adrenergic receptor agonists, has the property of good anxiolysis, sedation, and analgesic action. Clonidine prevents the hemodynamic response to intubation. Objectives: To study the response of oral clonidine premedication on hemodynamic changes during laparoscopy at various stages. Materials and Methods: A prospective randomized controlled study of 60 patients undergoing laparoscopic cholecystectomy was carried out at Medical College and S. S. G. Hospital, Baroda during years 2006 to 2008. They were divided into two groups of which Group CL premedicated with tablet Clonidine 3 µg/kg, 90 min before induction while Group C were not given any oral premedication. All hemodynamic parameters were observed intraoperatively and for 2 h postoperatively. Results: Demographic data in terms of age, sex, weight, height, and American Society of Anesthesiologists grade were comparable in both groups. Preoperative baseline parameter, i.e., pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), respiratory rate and SpO2 were comparable in both groups. Pulse rate varied from 76.2 ± 7.015 bpm to 88.3 ± 5.4 bpm in Group CL and it varied from 86.7 ± 4.78 bpm to 112.93 ± 5.13 bpm in Group C. SBP varied from 110.8± 9.1 mmHg to 128.13 ± 5.7 mmHg in group CL while it varied from 128.33 ± 6.59 mmHg to 159.6 ± 12.33 mmHg in Group C. DBP varied from 78.53 ± 3.44 to 83.93 ± 4.85 in group CL while it varied from 82.13 ± 3.23 to 99.47 ± 9.01 in Group C. Requirement of isoflurane to maintain MAP intraoperatively was 40% less in Group CL than Group C. There was no significant change seen in SpO2 in both groups and no fall in SpO2 seen intraoperatively in both groups. After 90 min of giving clonidine premedication in Group CL, all patients had sedation score of 2 while no sedation was found in patients of Group C. Only 2 patients (6.6%) in Group C had nausea, and one patient (3.3%) of Group CL had subcutaneous emphysema postoperatively. No other complications observed intra- or post-operatively which did not require any treatment. All patients of Group CL had dryness of mouth. Conclusion: With clonidine 3 µg/kg there is no rise in pulse rate and BP throughout laparoscopic cholecystectomy at various stages. Patients remain haemodynamically stable throughout laparoscopic surgery with clonidine. Clonidine also decreased the requirement of inhalation agent. No significant perioperative complications were found with the use of clonidine.
Authors and Affiliations
Mrunalini Patel, Neelam Parmar
Keywords
Related Articles
- EP ID EP304970
- DOI 10.5455/ijmsph.2017.1170024112015
- Views 65
- Downloads 0
Results of open reduction and internal fixation in closed bimalleolar Pott’s Fracture of Ankle in Adults
Background: The movement around ankle joint is very important because of the cultural practices, which involve squatting and sitting cross-legged. Bimalleolar Pott’s fractures are very common in ankle joint injuries...
A cross-sectional study on dementia in elderly persons living in old-age homes of Hyderabad, Telangana
Background: Dementia (cognitive impairment) is characterized by gradually declining memory and other cognitive abilities which reduce the quality of life of elderly people. The World Health Organization estimated that 2/...
The health related uses of social media among users in Saudi Arabia
Background: Social media refer to groups of social networking sites (SNS) that are used by many people to communicate and to share different information. Health - related issues became very popul...
Assessment of patient satisfaction: a descriptive study at outpatient department of a tertiary care public hospital in Jabalpur
Background: Patients satisfaction has always been important issue for physicians and hospital administrators. A patient is the ultimate consumer of the hospital. He is the person in distress and expects...
Therapeutic effect of common salt on umbilical granuloma in infants
Background: Umbilical granuloma is the most general umbilical difficulty in neonates and young infants. It is commonly noted by the parents owing to persistent drainage or moisture involving the umbilicus, after t...