Efficacy of dexmedetomidine versus clonidine in attenuating hemodynamic instability in surgeries performed laparoscopically: A randomized single-blinded trial

Abstract

Background: Various surgeries are being performed laparoscopically since the last decade owing to its collective benefits, yet pneumoperitoneum-related complications are plenty. Hemodynamic instability that is observed in surgeries performed laparoscopically impacts clinical recovery to a greater extent. Therefore, this study was devised to tackle this complication using drugs that suppressed this sympathetic response using alpha-2 sympatholytic agents. Aim: The aim was to compare the efficacy of dexmedetomidine and clonidine infusion in maintaining stable hemodynamics during the intraoperative period and possible adverse effects in the postoperative period in patients undergoing laparoscopic surgeries. Materials and Methods: This was a randomized single-blinded trial done in a tertiary care center. We included 52 patients (26 patients per group) who underwent laparoscopic surgeries, fit under the American Society of Anesthesiologists (I and II), and 18–60 years age group. Group 1 received intravenous (IV) infusion of dexmedetomidine at 0.3 μg/kg/h, and Group 2 received IV infusion of clonidine at 2 μg/kg/h. The baseline vital parameters and the changes after pneumoperitoneum were systematically recorded and compared. Results: Group 1 had significantly lower blood pressure with the similar trend even during the latter part of the surgery. Whereas pain scores were lower in Group 2. Conclusion: We conclude that both the drugs were similarly effective in attenuating the hemodynamic changes in response pneumoperitoneum with quite minimal or no apparent adverse effects.

Keywords

• clonidine
• dexmedetomidine
• laparoscopic surgery