A Comparative Study of Intravenously Administered Clonidine and Magnesium Sulphate on Hemodynamic Responses During Laparoscopic Cholecystectomy

Background & Objectives: Laparoscopic surgeries are associated with significant hemodynamic response. Magnesium and clonidine both are known to inhibit catecholamine and vasopressin release and attenuate hemodynamic response to pneumoperitoneum. This randomized, placebo controlled study has been designed to assess which agent attenuates hemodynamic stress response to pneumoperitoneum better.Methods: Ninety patients undergoing elective laparoscopic cholecystectomy were randomized into 3 groups of 30 each. The study drugs were given intravenously over 10 min prior to creation of pneumoperitoneum. Group C received 1mcg/kg of clonidine in 10 ml normal saline, group M received 50mg/kg magnesium sulphate in 10 ml normal saline and group NS received 10 ml normal saline. Blood pressure and heart rate were recorded before induction (baseline value), after the study drug administration, 5 minutes after creation of pneumoperitoneum and then for every 10 minutes.Results: Statistically significant rise in the mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product occurred, post pneumoperitoneum, in the control group (NS). Hemodynamic response to pneumoperitoneum was significantly attenuated in both the clonidine(C) and magnesium (M) groups. However, extubation time and time to response to verbal commands was significantly prolonged in the magnesium sulphate group. No other adverse effects were noted in any of the groups. Interpretation & Conclusion: Administration of magnesium sulphate or clonidine attenuates hemodynamic response to pneumoperitoneum with comparable efficacy