Comparison of effects of oral clonidine and pregabalin for haemodynamic stability during laparoscopic surgeries: A prospective randomized placebo control study

BACKGROUND: Hemodynamic responses of laparoscopy should be attenuated by the appropriate premedication. The present study evaluated the clinical efficacy of oral premedication with Clonidine 200 μg or Pregabalin 150 mg for hemodynamic stability during laparoscopic surgeries. METHODS: A total of 90 healthy adult patients aged 18 to 60 years with ASA physical status I & II of both gender, who met the inclusion criteria for elective laparoscopic surgeries, were randomized to receive Placebo Group I, Clonidine 200 μg Group II, or Pregabalin 150 mg, given 60 minutes before surgery as oral premedication. All groups were compared for heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure prior to premedication, before induction, after intubation 1 and 5 minutes, after pneumoperitoneum 1, 5, 15, 30 & 45 minutes, after pneumoperitoneum release, and after extubation. Intraoperative analgesic requirement, post operative sedation, pain scale and complications were also recorded. RESULTS: Both Clonidine and pregabalin were effective in producing intra operative hemodynamic stability as compared to the control group by blunting the stress response to pneumoperitonium but the hemodynamic stability is better with clonidine group than pregabalin group, which itself is better than placebo group. The pain scores was significantly reduced in clonidine and pregabalin groups when compared to the placebo group but the reduction in scores in the pregabalin group is significantly less than that of the clonidine group. The sedation score is higher in clonidine group when compared to placebo and pregabalin. Intraoperative fentanyl requirement is more with placebo group than pregabaline group, which itself higher than clonidine group. Drowsiness is more with clonidine group than pregabalin and placebo. Post operative nausea and vomiting incidence was similar in all groups. CONCLUSION: This study concluded that oral premedication with Clonidine 200 μg and Pregabalin 150mg produces better hemodynamic stability in laparoscopic surgeries but Clonidine produces better haemodynamic stability than Pregabalin. Both drugs has significantly reduces intraoperative and post operative analgesic requirements without significant post operative respiratory depression