Effect of oral clonidine premedication on hemodynamic responses during laparoscopic cholecystectomy

Background: Laparoscopic cholecystectomy has rapidly revolutionized gall bladder surgeries and has now become the gold standard for the treatment of cholelithiasis. Even though it has several advantages, creation of pneumoperitoneum for the surgical procedure can have several adverse haemodynamic and respiratory consequences. Thus, the present study was designed to evaluate the type and extent of haemodynamic changes associated with laparoscopic surgery and also to find out the efficacy of oral clonidine premedication in attenuation of such haemodynamic changes. Methods: In this prospective, randomized, double blinded comparative study, 60 patients between 18-60 years age group, 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 P with 30 patients in each group. Patients in Group C received premedication with oral clonidine 150μg and Group P received Tab. Vitamin C, 90 minutes prior to surgery. The two groups were compared with respect to haemodynamic parameters and sedation scores. Results: There was significant increase in all the haemodynamic variables in group P as compared to group C where the variables remained close to baseline values and patients in Group C had mild to moderate sedation without causing respiratory depression. Conclusions: Oral premedication with clonidine effectively attenuates the haemodynamic response to pneumoperitoneum and also provides sedation without respiratory depression, thus reducing anaesthetic requirement.