EFFICACY OF ORAL CLONIDINE VERSUS DIAZEPAM AS A PREMEDICATION AND AS AN ADJUNCT TO GENERAL ANESTHESIA IN SELECTIVE UPPER ABDOMINAL SURGERY

Background: Preanesthetic medication lessens preoperative anxiety, provides amnesia for preoperative and perioperative events and maintains hemodynamic stability by attenuating autonomic reflexes.1 Use of α-2 adrenoreceptor agonist like clonidine has a lot of advantages as a premedication agent due to the wide spread distribution of α-2 receptors throughout the central nervous system and rest of the body. Aim : To assess the efficacy of oral clonidine versus diazepam as a premedication and as an adjunct to general anesthesia in selective upper abdominal surgery Methodology: A comparative study was done on 50 patients in our hospital for duration of two years. The patients were divided into two groups of 25 each. Group I patients received 0.2 mg/kg of diazepam orally and patients in Group II received 3.5 micgm/kg of clonidine orally. Pre-anesthetic examination involved the overall assessment and selection of patients for the study. Sedation was measured by using a five graded scale. Subjective assessment for dizziness, nausea, headache and dryness of mouth was performed. Base line heart rate and blood pressure were recorded after fixing ECG leads and blood pressure cuff using noninvasive Hewlett Packard Blood Pressure monitor. Results : Sedation level among the clonidine group was grade 3 which is found to be statistically significant when compared to the diazepam group. The heart rate, systolic BP, diastolic BP and the MAP are statistically significantly lower among the clonidine group of patients when compared to the diazepam group at almost all the time intervals during the induction of anesthesia. The requirement of isoflurane among the clonidine group was only 0.5% when compared to 1% among diazepam group and the duration of analgesia was 8.83hrs in clonidine group whereas it was only 5.08hrs in diazepam group. Conclusion : The administration of oral clonidine is a simple and cost effective form of premedication in patients undergoing upper abdominal surgeries results in improved perioperative haemodynamic stability and reduction in anaesthetic requirements. In addition, it also reduces the post-operative analgesic requirements.