Premedication with clonidine versus fentanyl for intraoperative hemodynamic stability and recovery outcome during laparoscopic cholecystectomy under general anesthesia

Abstract

Background:Laparoscopic cholecystectomy under general anesthesia induced intraoperative hemodynamic responses which should be attenuated by appropriate premedication. The present study was aimed to compare the clinical efficacy of clonidine and fentanyl premedication during laparoscopic cholecystectomy for attenuation of hemodynamic responses with postoperative recovery outcome.Subjects and Methods:In this prospective randomized double blind study 64 adult consented patients of either sex with ASA I and II, scheduled for elective laparoscopic cholecystectomy under general anesthesia and met the inclusion criteria, were allocated into two groups of 32 patients. Group C patients have received intravenous clonidine 1μg kg-1 and Group F patients have received intravenous fentanyl 2μg kg-1 5 min before induction. Anesthetic and surgical techniques were standardized. All patients were assessed for intraoperative hemodynamic changes at specific time and postoperative recovery outcome.Results:Premedication with clonidine or fentanyl has attenuated the hemodynamic responses of laryngoscopy and laparoscopy. Clonidine was superior to fentanyl for intraoperative hemodynamic stability. No significant differences in the postoperative recovery outcome were observed between the groups. Nausea, vomiting, shivering and respiratory depression were comparable between groups.Conclusion:Premedication with clonidine or fentanyl has effectively attenuated the intraoperative hemodynamic responses of laparoscopic cholecystectomy.

Comparison between intravenous and intrathecal clonidine for postoperative analgesia of patients submitted to laparoscopic cholecystectomy: randomized clinical trial

“…Clonidine is an α2 adrenergic receptor, with central action on postoperative analgesia and hemodynamics. 10 , 11 , 12 This study compared the effects of the intrathecal and intravenous administration of clonidine as a component of a multimodal therapeutic strategy to reduce opioid requirements in the post-operative. 18 …”

“… 9 , 10 Using α2 adrenergic agonist drugs, such as clonidine, provides analgesia and sedation, and is associated with greater intra and postoperative hemodynamic stability. 11 , 12 , 13 …”

A randomized controlled study to compare hemodynamic effects between clonidine and pregabalin in laparoscopic cholecystectomy

“…[ 9 10 ] Even, the time periods at which the HR and BP were significantly different among the intervention groups were mostly similar. Gupta et al .,[ 17 ] reported hemodynamic variability after laryngoscopy with maximal rise after 1 min of laryngoscopy in the control population. They reported a statistically significant attenuation of HR and BM in premedicated groups ( P < 0.0001), with clonidine showing better stabilization than pregabalin.…”

Attenuation of pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum in laparoscopic cholecystectomy

“…여 공기배증 유도 전에 아편양제제 [7,15], clonidine [11,15,16], esmolol [17,18], magnesium sulfate [12], dexmedetomidine [18] p<0.01), but the degree of elevation was significantly reduced in the lidocaine-treated group than in the control group ( b) p<0.01).…”

“…EtCO2는 공기배증 동안 증가하였으나 통계적 의의가 없었고, 양 군간 차이도 없었다(p>0.05, Fig. 2 전술한 바와 같이 공기배증 유도 전에 아편양제제나 [7,15], clonidine [11,15,16], esmolol [17,18]…”