A Study of the Haemodynamic Response to Oral Clonidine as Pre–Medication in Laparoscopic Surgeries

Abstract

Introduction: Laparoscopic surgery is a boon for surgeons as it reduces tissue trauma, post-operative morbidity, hospital stay and healthcare costs. However, it is not possible to perform a laparoscopic procedure unless a proper anaesthetic procedure is available to combat the additional haemodynamic stress of pneumoperitoneum with CO₂ insufflation and the patient's position^1,2. Use of an alpha-2 against tablets such as clonidine helps in blunting the adverse haemodynamic response during laparoscopy^3,4. Aims of this study were: To study haemodynamic response to oral clonidine tablet during endotracheal intubation in laparoscopic surgery. To study haemodynamic response to oral clonidine tablet in the intraoperative period in laparoscopic surgery. To study side-effects of clonidine. Materials and Methods: This prospective placebo controlled study was conducted in the Department of Anaesthesiology, in a tertiary health care centre attached to a medical college. A total of 60 patients scheduled for laparoscopic surgery in the age group of 18-60 years belonging to ASA grade 1 & 2 were included in the study. After appropriate preoperative evaluation they were divided into 2 groups. Group C (n = 30) received Tab. Clonidine 150 mcg orally. Group V (n = 30) received a placebo Vitamin tablet. After appropriate premedication, patients were given general anaesthesia. Various parameters like pulse rate, Non-Invasive Blood Pressure (NIBP) including systolic, diastolic and mean arterial pressure, ETCO₂ were measured pre-operatively, during intubation and at various points intraoperatively. Statistical analysis was done using statistical package for Social Sciences Ver. 18. The results was expressed in mean and standard deviation. Independent t-test was used to compare mean of the two groups. For the purpose of this study, 95% confidence limit was chosen and corresponding p-value <0.05 was taken as statistically significant. Conclusion: We found that pre-medication with oral clonidine provides haemodynamic stability and protection against the stress response triggered by laryngoscopy, intubation and pneumoperitoneum with CO₂ in patients undergoing laparoscopic surgery. It also was found to reduce nausea, vomiting and shivering post-operatively.