Effect of Oral Clonidine Premedication on Perioperative Haemodynamic Response and Post Operative Analgesic Requirements for Patients Undergoing Laparoscopic Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 4
Abstract
Background: The first focus on haemodynamic response to laryngoscopy and tracheal intubation was done in 1950 by Burstein. King et al in (1951) described the abnormal circulatory reaction to laryngoscopy. Its association with a rise in blood pressure, tachycardia and increased level of catecholamines was highlighted by Prys-Roberts in (1971) and by Siedlecki in 1975. Recognizing the hazardous effect of such reflex reactions, many techniques were studied and clinically tried to obtund these reactions. At the same time, The first publication on diagnostic laparoscopy by Raoul Palmer appeared in the early 1950s, followed by the publication of Frangenheim and Semm. Hans Lindermann and Kurt Semmpractised CO2 hysteroscopy during the mid-1970s. However this procedure is not risk free, In fact it produces significant changes in haemodynamically compromised patients.The hallmark of laparoscopy is creation of carbon dioxide pneumoperitonium and change in the patients position from trendelenburg to reverse trendelenburg. It also results in stress hormone responses (cortisol, epinephrine and non–epinephrine) especially when CO2 pneumoperitonium is used concomitantly. Laryngoscopy with or without tracheal intubation amounts to a highly noxious stimulus to the homeostasis of the patient. Aims: Designed to assess the effect of oral Clonidine premedication on hemodynamic response to endotracheal intubation and to compare intra-operative haemodynamic parameters, pain and sedation scores, time of first post-operative analgesia and dverse effects Material and Method: Total 60 patients ASA grade I and II in the age group 20 to 55 years were included in this study and they were randomly divided into two groups: Group 1 (n=30), patient received oral clonidine 150 mcg orally 90 min before induction Group 2 (n=30), patients received oral vitamin C 100 mg orally 90 min before induction All patients were posted for elective surgeries and were randomly selected. Conclusion: The basal and perioperative arterial blood pressure and heart rate after giving premedication was lower in clonidine group as compared to placebo group. Time for 1st post-operative analgesia requirement in clonidine group was significantly prolonged in comparison with the ranitidine group.
Authors and Affiliations
Rohan R. Nayak
Keywords
Related Articles
- EP ID EP535643
- DOI 10.21088/ijaa.2349.8471.5418.17
- Views 87
- Downloads 0
A Prospective Randomised Control Study to Compare Hyperglycemic Stress Response to General Anaesthesia in Non Diabetics and Controlled Diabetics Posted for Elective Surgical Procedures
Diabetic patients presenting for elective surgical procedures will place an increasing burden on anaesthetic services. The effects of surgical stress and anesthesia result in a a hypermetabolic stress response, referred...
Comparison Between Intravenous Fentanyl and Dexmedetomidine to Decrease Sevoflurane – Induced Agitation in Paediatric Patients Undergoing Lower Abdominal Surgery: A Prospective Randomized Observational Study
Introduction: Sevoflurane is widely used in paediatric anesthesia. It has a rapid induction and rapid recovery profile. It is pleasant, non-pungent and non irritant to the respiratory airways. Emergence agitation (EA) in...
A Comparative Study of Hemodynamic Response and Ease of Intubation in Patients Intubated by Direct Laryngoscopy Versus Lightwand
Introduction: Direct laryngoscopic endotracheal intubation is associated with varying degrees of sympathetic activity which may be detrimental in patients with coexisting conditions, such as coronary artery disease, elev...
Ffficacy of Low Dose Intrathecal Fentanyl Added to Bupivacaine in Cesarean Section: An Observational Study
Context: Potentiating of the effects of intrathecal Local anesthetics by addition of Opioids for intraabdominal surgeries is a well established fact. Aims: To study effects of low dose fentanyl (12.5mcg) on the spinal bl...
A Comparative Evaluation of Intrathecal Administration of Hyperbaric Bupivacaine alone and in Combination of Different Low Doses of Hyperbaric Bupivacaine with Fentanyl in Cesarean Section
Background: This randomized study was conducted to compare the synergistic effect of intrathecally administered fentanyl and hyperbaric bupivacaine on hemodynamic, sensory and motor block characteristics alongwith their...