Low dose oral clonidine as premedication in laparoscopic surgery

Introduction: Clonidine modulates the cardiovascular changes caused by pneumoperitoneum in laparoscopic procedures. This study aims at comparing the haemodynamic variation, requirement of intraoperative opiods (fentanyl) and inhalational agents(isoflurane), incidence of postoperative complications and postoperative analgesic and oxygen requirement between low dose oral clonidine(100mcg) and placebo group in laparoscopic surgeries. Materials and Method: Study group was randomly administered either tablet Clonidine 100mcg (test group) or a multivitamin tablet (control group) 90 minutes before the induction of anaesthesia. Intraoperative heart rate and arterial blood pressure (systolic, diastolic and mean) were recorded at various intervals. Intraoperative requirement of opioids (fentanyl) and inhalational agents (isoflurane) were recorded. Presence of sedation, nausea, vomiting and shivering in postoperative period were noted. Requirement of oxygen and analgesics in the postoperative period were also recorded. Results: Clonidine group had a significantly low heart rate and arterial pressure (systolic, diastolic and mean) compared to placebo group at various interval. Intraoperative requirement of opioids(fentanyl) and inhalational agents(isoflurane) were lower in test group. Postoperative sedation and oxygen requirement was similar in both groups. Postoperative complications (vomiting, nausea, pain and shivering) were also less in test group. Discussion: Low dose oral clonidine(100mcg) is an efficient cardiovascular modulator when given as premedication in patients undergoing laparoscopic surgeries. It not only provides good perioperative haemodynamic control but also lowers the requirement of anaesthetic agents. It has an added advantage of lesser postoperative complications like shivering, pain, nausea and vomiting. Postoperative analgesic and oxygen requirement is also less in patients taking low dose oral clonidine as premedication. Conclusion: Low dose oral clonidine is a very efficient, easy to administer and cost effective premedication drug during laparoscopic procedures.