Background:Carbon dioxide pneumoperitoneum for laparoscopic surgery increases arterial pressures, heart rate, and systemic vascular resistance. In this randomized double-blind placebo-controlled clinical study, we investigated the efficacy of gabapentin premedication to provide perioperative hemodynamic stability in patients undergoing laparoscopic cholecystectomy.Materials and Methods:Sixty patients, of either sex (18–65 years of age) undergoing elective laparoscopic cholecystectomy were randomly allocated to two groups of 30 patients each. Patients of group G received oral gabapentin 900 mg 2 h before induction of anesthesia, while patients in group P received placebo at the same time.Results:Mean arterial pressure in patients of group G were significantly lower (P < 0.05) after tracheal intubation and pneumoperitoneum and remained lower, as compared to group P, throughout the pneumoperitoneum. Similarly, heart rate in group G was significantly lower (P < 0.05) after tracheal intubation and pneumoperitoneum and remained lower, in comparison to group P, throughout the peumoperitoneum. Intravenous labetalol was required, to control intraoperative hypertension, in 33.3% (10 out of 30) patients in group P. There was no significant difference in the incidence of adverse effects between the two groups.Conclusion:Gabapentin premedication provided perioperative hemodynamic stability during laparoscopic surgery.

This randomised, placebo-controlled, double-blind study was designed to assess the effect of intravenous clonidine and magnesium sulphate on intraoperative haemodynamics, anaesthetic consumption and postoperative recovery. Seventy five patients undergoing elective upper limb orthopaedic surgery were randomised into three groups. Group C received clonidine 3 μg/kg as a bolus before induction and 1μg/kg/hour by infusion intraopertively. Group M received magnesium sulphate 30 mg/kg as a bolus before induction and 10 mg/kg/hour by infusion. Group P received same volume of isotonic saline. Anaesthesia was induced and maintained with fentanyl citrate and propofol. Muscular relaxation was achieved by vecuronium bromide. Induction time, recovery time and consumption of propofol as well as fentanyl citrate were recorded. Induction of anaesthesia was rapid with both clonidine and magnesium sulphate. Time of bispectral index (BIS) to reach 60 was significantly lower in Group C and Group M (P < 0.0001). Requirements of propofol and fentanyl were significantly less in Group C and Group M (P < 0.001). Postoperative recovery was slower in Group M compared with other two groups (P < 0.001). Perioperative use of both clonidine and magnesium sulphate significantly reduced the consumption of propofol and fentanyl citrate. Magnesium sulphate caused a delayed recovery.

Background and Aims:In an attempt to improve the recovery and early rehabilitation after arthroscopic knee surgery, various medications have been administered via intra-articular route to prolong the duration and improve the quality of postoperative analgesia. Among the potentially effective substances, steroids like dexamethasone could be of particular interest.Materials and Methods:Fifty patients undergoing elective knee arthroscopy were randomly assigned to one of the following groups containing 25 patients each. Group D patients received 8 mg (2 mL) of dexamethasone added to 18 mL of 0.25% levobupivacaine intra-articularly, (total volume 20 mL). Group L patients received 18 mL of 0.25% levobupivacaine and 2 mL of isotonic saline (20 mL in total) intra-articularly. Analgesic effect was evaluated by measuring pain intensity visual analogue scale score and duration of analgesia.Results:A longer delay was observed between intra-articular injection of study medication and first requirement of supplementary analgesic in Group D (10.24 ± 2.8 hours) compared with Group L (5.48 ± 1.6 h). Total consumption of diclofenac sodium in first 24 h in postoperative period was significantly less in Group D. No significant side effects were noted.Conclusion:Dexamethasone, used as adjunct to levobupivacaine in patients undergoing arthroscopic knee surgery, improves the quality and prolongs the duration of postoperative analgesia.

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