Does Clonidine Affect the Anti-Inflammatory Response of IL-10 in Patients Undergoing Laparoscopic Cholecystectomy?

Abstract

BACKGROUND As immune mediators, cytokines are thought to regulate many biological functions. Tissue injury affects the immune system which rapidly produces pro-inflammatory and anti-inflammatory cytokines that causes injury and spread of infection to provide an appropriate environment for tissue healing. The surgery causes stressful response which leads to changes in cytokine level. Our aim was to evaluate the effects of anti-inflammatory and hemodynamic stress response of clonidine during laparoscopic cholecystectomy. METHODS Thirty patients [American Society of Anesthesiologists (ASA) Grade I and Grade II] were selected and randomly assigned into two groups. Group A (Normal Saline Group): Patients received 20 ml of normal saline intravenous and Group B (Clonidine Group): patients received clonidine 1 µgm/Kg + normal saline (20 ml) intravenous, 15 minutes before induction. Blood concentrations of antiinflammatory cytokines IL-10, was determined preoperatively, just after extubation and 12 hours after the operation. The cytokines assay was performed with the help of commercially available ELISA kit. RESULTS The demographic data age, gender, weight, height, BMI, ASA grade and baseline hemodynamic variables were comparable between group A and group B. Clonidine (1 µgm/kg) as a premedication for general anaesthesia had significantly better hemodynamic control as compared to normal saline group. IL-10 level was increased at extubation and at 12 hours postoperatively in both groups, but level was comparatively more in clonidine group as compared to normal saline group (at extubation (53.73±12.85 vs. 47.96±14.99) and at 12 hrs. postoperatively (110.43±13.58 vs. 96.64±44.76). Therefore, anti-inflammatory response IL-10 was higher in clonidine group as compared to the normal saline group. CONCLUSIONS Intravenous clonidine as a pre-medication could be recommended to maintain hemodynamic stability with minimal side effects during laparoscopic surgeries in ASA I/II patients. The anti-inflammatory response was greater in clonidine group as compared to saline group but not significantly different.