COMPARATIVE STUDY OF ITRAVENOUS NITROGLYCERINE AND CLONIDINE ON HAEMODYNAMIC STABILITY IN LAPROSCOPIC CHOLECYSTECTOMY.

Clonidine has been shown to reduce perioperative haemodynamic instability. The aim of the study was to investigate the clinical efficiency of intravenous clonidine premedication with nitroglycerine infusion in prevention of haemodynamic response associated with pneumoperitoneum. Sixty adult patients of ASA physical status I& II, scheduled for elective laparoscopic cholecystectomy were recruited for a prospective randomized, double-blinded comparative study. They were randomly allocated to one of the two groups to receive either nitroglycerine infusion (Group I) or i.v. clonidine 2mg (Group II), before induction of anaesthesia. Significant rise in heart rate was observed following pneumoperitoneum in Group I as compared to Group II (99.23±14.02 Vs 81.26±8.40 bpm). Similarly, while systolic arterial pressure, diastolic arterial pressure and mean arterial pressure changes were insignificant in both the groups following pneumoperitoneum. Nitroglycerine drip was started in 2 patients in Group II to control intraoperative hypertension. Incidence of postoperative nausea-vomiting and shivering was less in GroupII. To conclude, clonidine premedication provides better perioperative haemodynamic stability, hence it can be recommended as a routine premedication for laparoscopic cholecystectomy.