Effects of Oral Clonidine Premedication on Haemodynamic Responses During Laparoscopic Cholecystectomy –a Randomized Control Study

Purpose: Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. The pneumoperitoneum used for laparoscopic procedures results in significant hemodynamic and respiratory responses which might be harmful especially in cardiac patients. Clonidine has anti-hypertensive properties and augments the effects of anesthesia, thus it is a potentially an ideal agent to contain the stress response to pneumoperitoneum. We undertook this study to evaluate the clinical efficacy of oral clonidine premedication in patients undergoing laparoscopic cholecystectomies. Methods: 100 patients of ASA grade I–II, scheduled for elective laparoscopic cholecystectomy under general anaesthesia were randomly allocated to receive premedication with either oral clonidine 150 μg (Group I, n = 50) or placebo (Group II, n = 50) 90 minutes prior to induction. The patients were managed with a standard general anaesthetic. The two groups were compared with respect to haemodynamic parameters, pain and sedation scores and incidence of adverse effects like nausea-vomiting, shivering, hypotension, bradycardia etc. Results:  Haemodynamic parameters i.e. pulse rate, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower and stable in the clonidine group as compared to placebo group. Patients receiving oral clonidine premedication had less anxiety and no incidence of post –operative shivering. Clonidine also decreased need of postoperative analgesics and incidence of postoperative nausea / vomiting. Conclusion: From our study we found that clonidine in dose of 150 mcg can be used effectively and safely in ASA class I & II patients to control the hemodynamic changes which occur during laparoscopic cholecystectomy.