A Comparison Between the Effects of Single-Dose Oral Gabapentin and Oral Clonidine on Hemodynamic Parameters in Laparoscopic Surgeries: A Randomized Controlled Trial

Abstract

Background and objectiveLaparoscopic surgeries can result in exaggerated sympathetic responses due to pneumoperitoneum. Many drugs including clonidine and gabapentin have been evaluated to attenuate the hemodynamic response to abdominal insufflation. In light of this, this study was conducted to compare the effects of preoperative administration of oral gabapentin with those of clonidine on intraoperative hemodynamic parameters in patients undergoing laparoscopic surgeries. MethodologyA prospective, randomized, double-blinded comparative trial spanning a period of one year was conducted involving 150 patients scheduled to undergo elective laparoscopic surgeries at a tertiary hospital. Patients who fulfilled the inclusion criteria were randomly allocated into three groups: to receive oral gabapentin 300 mg (Group G) or oral clonidine 150 mcg (Group CL) or a placebo tablet (Group C). Standard anesthetic protocols were followed during the surgery and the mean arterial pressure (MAP), heart rate (HR), postoperative pain as assessed by visual analog scale (VAS) scores, postoperative analgesic consumption, sedation scores, and complications like nausea, vomiting, and dry mouth were recorded and analyzed. ResultsHR and MAP were significantly reduced in the intervention groups (clonidine and gabapentin) compared to the control group. There was a statistically significant reduction in MAP and HR in patients on oral clonidine compared to patients on gabapentin. Postoperative pain as assessed by VAS score was better in the intervention groups compared to patients who were administered a placebo. Postoperative analgesic consumption was significantly lower in patients on clonidine and gabapentin compared to the control group. Patients on oral gabapentin received lower doses of tramadol compared to patients on clonidine. Postoperative sedation as assessed by the Ramsay sedation scale (RSS) score was higher in patients on oral gabapentin. Complications like postoperative nausea and vomiting were significantly reduced in the intervention groups, while dryness of mouth was more prevalent in patients on clonidine. ConclusionBased on our findings, oral clonidine is more effective in attenuating hemodynamic response to pneumoperitoneum compared to oral gabapentin. Postoperative pain was lower in intervention groups compared to the control group. However, patients on gabapentin required a lower dose of analgesics postoperatively compared to patients on clonidine. Postoperative sedation was also more pronounced in patients on gabapentin while dryness of mouth was more common in patients on oral clonidine.