Intravenous clonidine for suppression of haemodynamic response to laparoscopy- a prospective randomised, placebo controlled, single centre study

Bhalerao, Pradnya M; Thombre, Shalini; Kapse, Upendra S.; Targe, Kunal V.

doi:10.18203/2349-3933.ijam20172273

Cited by 3 publications

(4 citation statements)

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“…17 Bhalereo et al found that Clonidine given i.v as premedicant was effective in preventing stress induced heamodynamic response. 18 Chawda, Pareek and Mehta found that 0.2mg/kg of nalbuphine given 3-5 minutes before intubation is effective in preventing the pressor response. 19 Effectivity of Nalbuphine in dose of 0.2 mg/kg in achieving acceptably stable vital parameters and good anesthetic effect were proved by study of Nath R et al 20 These drugs have been studied and compared individually and amongst each other but have never been studied together in similar set of patients.…”

Section: Discussionmentioning

confidence: 97%

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Comparison of fentanyl, clonidine and nalbuphine for attenuation of pressor response during endotracheal intubation under general anaesthesia

Makker¹,

Mehra²,

Khanna³

2020

IJCA

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Background: Increased sympathoadrenal activity invariably occurs during endotracheal intubation. Various drugs have been used to obtund this pressor response. This study was done to find out most favourable drug among fentanyl, nalbuphine and clonidine for prevention of this pressor response. Materials and Methods: This was a randomized, prospective study involving ninety patients of ASA grade 1, equally divided into three groups. Group F, C and N received fentanyl 2 mcg /kg, Clonidine 2 mcg/kg and nalbuphine 2mg/kg i.v respectively, 5 minutes prior to induction. Vitals parameters were noted at frequent intervals Chi square test and Anova test were used for statistical analysis. P value <0.05 was considered as statistically significant. Results: Maximum increase in heart rate and blood pressure was seen at the time of intubation in F and N groups, whereas decrease in these parameters occured with clonIdine, difference was found to be stastistically significant. Haemodynamic stability was seen in F and N group after 5 minutes of intubation. Clonidine showed maximum decrease in heart rate and systolic as well as diastolic blood pressure at all time intervals from intubation as compared to other two groups. Conclusion: In this study it was found that Clonidine produced an earlier and more stable haemodynamics as compared to Fentanyl and Nalbuphine, and it can be concluded that Clonidine given intravenously in doses of 2 mcg/kg 5 minutes prior to intubation is superior to Fentanyl and Nalbuphine in preventing heamodynamic changes at the time of laryngoscopy and intubation.

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Section: Discussionmentioning

confidence: 97%

“…31 Our findings are also in concondrance with Bhalereo et al who found that Clonidine given i.v as premedicant was effective in preventing stress induced heamodynamic response. 18…”

Section: Discussionmentioning

confidence: 99%

Comparison of fentanyl, clonidine and nalbuphine for attenuation of pressor response during endotracheal intubation under general anaesthesia

Makker¹,

Mehra²,

Khanna³

2020

IJCA

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“…They concluded that premedication with intravenous clonidine is effective method to provide stable hemodynamics and protection against stress response induced during laparoscopic cholecystectomy. [15] Ray M, Bhattacharjee DP et al concluded in their study that immediately after laryngoscopy and intubation, heart rate increased by 10 bpm in patients of clonidine group, while mean arterial pressure in clonidine group decreased significantly for all measurements with the exception during intubation and after induction. [16] Altan A et al studied clonidine in dose of 3µg/kg and found that, mean arterial pressure increased by 16 mm Hg in control group, whereas in clonidine group, the mean arterial pressure increased only by 10 mmHg, which showed clonidine has significant blunting effect of pressor response of laryngoscopy and intubation.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Hemodynamic Changes during Direct Laryngoscopy and Intubation by Intravenous Clonidine or Nalbuphine Premedication - A Comparative Evaluation

Bansal

Gupta

Kumar

et al. 2019

AAN

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Background: Accentuated hemodynamic changes during direct laryngoscopy can be modified by appropriate premedication. The present study was aimed to comparatively evaluate the clinical efficacy of intravenous clonidine with nalbuphine premedication for reduction in hemodynamic changes during direct laryngoscopy and intubation. Subjects and Methods: Sixty adult consenting patients of ASA physical status I and II of either gender, were randomized into two equal groups of 30 patients each to receive either clonidine (2 µg/kg) Group I or nalbuphine (0.2 mg/kg) Group II, intravenously 10 minutes before induction. Anesthetic technique was standardised and direct laryngoscopy with intubation was facilitated with vecuronium bromide. Changes in heart rate, arterial blood pressure and ECG were recorded at baseline, after giving study drug, after laryngoscopy and intubation, then after at 1st, 2nd, 3rd, 5th, 10th, and 15th min of intubation and were noted as primary end points. Any side effects and complications were recorded as secondary end points. Results: After premedication in patients of comparable demographic profile, the fall in heart rate and blood pressure showed statistically significant difference between the groups. After laryngoscopy and intubation, the increase in mean heart rate and mean blood pressure occurred immediately in patients of both groups but persisted up to 5 to 7 min in patients of clonidine group and up to 10 minutes in patients of nalbuphine group with statistically significant difference between the groups. Conclusion: Intravenous clonidine premedication (2 µg/kg) could effectively reduce the hemodynamic changes during direct laryngoscopy and intubation when compared to intravenous nalbuphine (0.2 mg/kg), administered 10 min before induction.

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“…4 Single dose clonidine has also been effective in attenuating haemodynamic response to capnoperitoneum. As the half-life of clonidine is 9-12 hours intravenous clonidine, single dose has been used in various doses ranging from 1mcg/kg 7,8 bodyweight to 8 mcg/kg 1 bodyweight. Higher doses have produced more incidences of hypotension whereas 1 mcg/kg bodyweight was found to be effective in attenuating haemodynamic response without many side effects.…”

Section: Introductionmentioning

confidence: 99%

To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laproscopic assisted vaginal hysterectomy under general anesthesia

Gandhi¹,

Masamaddi²,

Amith³

2021

IJCA

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Advent of Laparoscopy have benefitted patients in terms of lesser tissue damage, early ambulation, decreased duration of hospital stay and reduced analgesic needs. However caproperitoneum and position of patient during laparoscopic procedure induces pathophysiological changes that may potentially complicate anesthetic management. Various pharmacological methods have been tried to overcome complications associated with pneumoperitoneum. One among those drugs is Clonidine, a centrally acting α 2-adrenergic receptors agonist has sedative, anxiolytic, analgesic properties and stabilizes circulatory system. It diminishes stress response hence increases perioperative circulatory stability in patients undergoing laparoscopic surgeries. In addition, it increases cardiac bar reflex sensitivity in hypertensive individuals, and thus, stabilizes blood pressure by enhancing the role of changes in heart rate. Objectives: To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laparoscopic assisted vaginal hysterectomy under general anesthesia. Materials and Methods: Patients were divided randomly into 2 groups (A group & B group) of 30 each. Patients assigned to group a, received 50 mcg of clonidine in 50ml of normal saline over 10 minutes 10 minutes before induction. Patients assigned to group B, received intrathecal clonidine 50 mcg in 1 ml in sitting position at L3-L4 interspace using 27G quincke's spinal needle just before induction. Intraoperative monitoring included heart rate (HR), continuous electrocardiography, noninvasive systolic (SBP), diastolic (DBP), mean blood pressure (MBP), pulse oximetry (SpO 2) and EtCO 2. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at regular interval and plotted on graph. Results: During capnoperitoneum, mean HR values, mean SBP values, mean DBP values, mean MAP values in (IT) group B were below the baseline and that in group A (IV) were near the baseline. Conclusion: Efficacy of Intrathecal route of clonidine administration during laparoscopic hysterectomy surgeries have better control of heart rate, mean systolic and diastolic blood pressure and mean arterial pressure is better during capnoperitoneum compared to intra venous clonidine. But post-operative sedation and adverse effects in both routes are statistically insignificant.

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Intravenous clonidine for suppression of haemodynamic response to laparoscopy- a prospective randomised, placebo controlled, single centre study

Cited by 3 publications

References 1 publication

Comparison of fentanyl, clonidine and nalbuphine for attenuation of pressor response during endotracheal intubation under general anaesthesia

Comparison of fentanyl, clonidine and nalbuphine for attenuation of pressor response during endotracheal intubation under general anaesthesia

Reduction in Hemodynamic Changes during Direct Laryngoscopy and Intubation by Intravenous Clonidine or Nalbuphine Premedication - A Comparative Evaluation

To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laproscopic assisted vaginal hysterectomy under general anesthesia

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