Oral clonidine: a simple yet effective and safe premedicant for hemodynamic stability during laparoscopic surgery and a calm post-operative period

Background: Laparoscopy is the essence of modern surgery but the carbon dioxide pneumoperitoneum used therein significantly impairs patient’s cardiopulmonary function. Clonidine, by its central sympatholysis, reduces perioperative hemodynamic instability and also has multiple added advantages in post-operative period.Methods: In this prospective, randomized, double-blind, placebo-controlled study on 60 ASA I/II patients, clonidine 150 µg for weight <55 kg and 200 µg for weight >55 kg was administered per oral to 30 patients (clonidine group) 90 minutes before induction of general anaesthesia and intra-operative haemodynamics were monitored at specific time periods and compared with the placebo group patients (n=30) who received oral vitamin C. We also noted pre-operative anxiety score, post-operative sedation and pain scores and the presence of nausea-vomiting, shivering and dry mouth at the end of first and sixth postoperative hours.Results: Clonidine group patients remained haemodynamically stable throughout the intra-operative period. In clonidine group, less number of patients required fentanyl for tachycardia (1 vs 11) and NTG for hypertension (none vs 7). Similarly the pain and anxiety scores were significantly less in clonidine group patients. At the end of first postoperative hour incidence of pain, shivering and vomiting in placebo group was 33%, 36% and 20% respectively whereas in clonidine group incidence was 6%, 0 and 0. At the end of 6 post-operative hours, incidence of pain and vomiting was 73% and 36% in placebo group whereas it was 10% and 0 in clonidine group.Conclusions: Oral clonidine in the present dose is able to maintain stable intra-operative haemodynamics and achieve a calm post-operative period during laparoscopic surgeries in ASA I/II patients.