Effect of Oral Clonidine Premedication on Induction Dose of Propofol and Perioperative Haemodynamic Parameters in Patients Undergoing Laparoscopic Cholecystectomy: A Double-blinded Randomised Controlled Study

Abstract

Introduction: Clonidine increases the effects of anaesthesia and possesses antihypertensive qualities. During laparoscopic cholecystectomy, pneumoperitoneum is created by inflating Carbon Dioxide (CO2), which stimulates autonomic pathways, resulting in catecholamine release, activation of the renin-angiotensin system and vasopressin release. Clonidine may be an ideal agent for controlling the stress response to pneumoperitoneum during laparoscopic surgery. Aim: To observe the clinical efficacy of two different dosages of oral clonidine premedication on the induction dose of propofol and changes in perioperative haemodynamic parameters in patients undergoing laparoscopic cholecystectomy. Materials and Methods: This randomised, double-blinded study was conducted at the Department of Anaesthesiology, Uttar Pradesh University of Medical Sciences (UPUMS), Saifai, Etawah, India, from January 2019 to December 2020. The study examined 60 patients with American Society of Anaesthesiologists (ASA) grades I and II who were scheduled for elective laparoscopic cholecystectomy under general anaesthesia. One hour before induction, the patients were randomly assigned to three groups for premedication: Group A (n=20) received a placebo, group B (n=20) received 150 μg of oral clonidine and group C (n=20) received 300 μg of oral clonidine. The patients were managed with standard general anaesthesia. Haemodynamic parameters and the propofol induction dose of the three groups were compared using an unpaired t-test and one-way Analysis of Variance (ANOVA); a p-value of B) maintained haemodynamic variables better than the placebo group (A) and the clonidine groups also experienced a significant reduction in the induction dose of propofol. In comparing the two dosages of oral clonidine, it was found that the higher dose (group C) was superior in attenuating the pressure response to laryngoscopy, intubation, pneumoperitoneum and extubation.

Keywords

• airway extubation
• antihypertensive agent
• extubation
• laryngoscopy
• pneumoperitoneum