Laparoscopic cholecystectomy is a gold standard
surgical procedure for gallbladder operation. It causes altered haemodynamic responses due to
pneumoperitoneum and
surgical procedure also causes high incidence of
postoperative nausea &
vomiting.
Clonidine has been shown to reduce intraoperative haemodynamic instability. This randomized prospective single blind clinical study was designed to evaluate the efficacy of oral
clonidine premedication for attenuation of haemodynamic responses associated with
pneumoperitoneum & also reduce the incidence of
postoperative nausea &
vomiting and carried out in the department of Anaesthesia
Analgesia and
Intensive care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to June 2010. Sixty adult patients of ASA physical status I & II scheduled for elective laparoscopic cholecystecomy were recruited for a prospective randomized single blind study. They were selected randomized into two equal groups, thirty in each group. Group A received no
premedication & Group B (
Clonidine) received
clonidine (100μgm) orally 60 minutes before induction of anaesthesia. Pulse rate, mean arterial pressure were recorded prior to induction, 2 minutes after endotracheal intubation, before
pneumoperitoneum, 10 minutes & 20 minutes after
pneumoperitoneum, 10 minutes after release of
carbon dioxide & 10 minutes after extubation. Patients in Group B (
Clonidine) maintained greater haemodynamic stability intraoperatively compare to Group A after intubation, during
pneumoperitoneum and also extubation. Pulse rate & mean arterial pressure significantly varies in Group A compare with Group B (
Clonidine) at different times of
intraoperative period (p<0.05).
Postoperative nausea &
vomiting was significantly less in Group B (
Clonidine).
Premedication with oral
clonidine attenuates the haemodynamic responses produced by
pneumoperitoneum during
laparoscopic cholecystectomy and also significantly
nausea and
vomiting, results better patient satisfaction and cost effective.