A Comparative Evaluation Of Intravenous Clonidine And Dexmedetomidine On Perioperative Hemodynamic During Pneumoperitoneum In Laparoscopic Cholecystectomy
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 8, Pages 1933-1941
AbstractBackground: Multiple agents are used for laparoscopic cholecystectomy since laparoscopic cholecystectomy is routinely performed surgery and desirable to have a stable intraoperative hemodynamic status by avoiding hypotension, hypertension or tachycardia. The search for ideal agent is still ongoing, alpha -2 adrenergic agonist have created interest in manner. So, the present study was conducted to compare the beneficial effect of clonidine and dexmedetomidine during laparoscopic cholecystectomy in maintain perioperative cardiovascular stability.
Methods: The present double blind randomized, prospective clinical study was carried out among patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia for a duration of 2 years. The sample size was calculated as 90 using formula: n=4pq/d2 and were divided equally into groups A (control), group B (clonidine) and group C (dexmedetomidine). Preanesthetic assessment of all the selected patients were done with complete history, general examination, airway assessment, systemic examination along with laboratory investigations. During perioperative period, hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded various intervals.
Results: Increase in heart rate was statistically insignificant in all the groups at baseline (B) and just after induction (D0).After infusion of drugs, increase in heart rate was significantly lower in all the intervals in Dexmedetomidine group and Clonidine group comparing with Control group.On comparing dexmedetomidine group with clonidine group, insignificant fall (p>0.05) in DBP were observed at all intervals except at 30 minutes after pneumoperitoneum (APN30) and after reversal(DBP_AR).While comparing Dexmedetomidine group with clonidine group, insignificant fall (p>0.05) in SBP and MAP were observed at all intervals except at 50 minutes after pneumoperitoneum (APN50).While comparing Clonidine with Dexmedetomidine, significantly decrease heart rate was observed in dexmedetomidine group.
Conclusion: Creation of pneumoperitoneum in laparoscopic abdominal surgeries produces significant increase of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP). During pneumoperitoneum in laparoscopic abdominal surgeries both intravenous clonidine and intravenous dexmedetomidine results to attenuate in all hemodynamic parameters (HR, SBP, DBP and MAP) During pneumoperitoneum in laparoscopic surgeries heart rate is better controlled by dexmedetomidine.
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