Effects of clonidine premedication on perioperative hemodynamic response, anesthetic requirements and postoperative analgesia for patients undergoing laparoscopic gynecological surgeries: A randomized study

Abstract

The creation of carbon dioxide (CO) pneumoperitoneum is frequent in laparoscopy, but has significant effect on the cardiopulmonary function of the patient. Clonidine by its central sympatholytic action reduces perioperative hemodynamic instability and has several advantages in the postoperative period, hence we consider it to be an effective premedication to contain the stress response to intubation and laparoscopy. With informed consent, 56 patients scheduled for elective laparoscopic gynecological surgeries under general anesthesia were randomly allocated into two groups to receive premedication with either oral Clonidine 100 µg (Group I, n = 28) or Vitamin C as placebo (Group II, n = 28) 90 minutes prior to induction. A balanced general anesthesia was used to manage these patients. Hemodynamic parameters, Sevoflurane concentration, pain and sedation scores, time to request analgesics, 24hr cumulative analgesic requirements and adverse effects between the two groups were collected as data and compared using Two sample t-test and Fisher’s exact test.When compared to the control group, oral Clonidine was found to be considerably superior significantly (p =0.00) in terms of maintaining stable hemodynamics (i.e. In group I, Mean HR ranged from 76.11±12.21 to 94.57±13.75, while in group II, it ranged from 79.04±7.11 to 112.00±12.75 and MAP ranged from 83.07±6.50 to 93.64±14.09 in group I, while in group II, it ranged from 88.04±9.03 to 116.14±13.23), having a Sevoflurane sparing effect and having a longer time (6.5 ± 1.6 hours) between the first request for analgesia postoperatively. In patients undergoing laparoscopic gynecological surgeries, administration of oral Clonidine 100µg as a premedication improves perioperative hemodynamic stability and reduces the intraoperative anesthetic and post-operative analgesic requirements.