Comparative Study of Oral Clonidine Versus Intravenous Esmolol In Attenuation of Hemodynamic Changes During Laparoscopic Surgeries
Keywords:
Clonidine, Esmolol, Laparoscopic surgeries, PneumoperitoniumAbstract
Background: Laparoscopy is the essence of modern surgery but the carbon dioxide pneumoperitoneum used there in significantly impairs patients cardiopulmonary function. Both Clonidine and Esmolol are known to inhibit catecholamine and vasopressin release and attenuate hemodynamic response to pneumoperitoneum. This randomized double blinded study was carried out to assess which agent attenuates hemodynamic stress response to pneumoperitoneum better in laparoscopic surgeries. Materials & Methods: A total of 60 patients scheduled to undergo laparoscopic surgeries were randomly assigned into two groups: Group A received 150?g Clonidine orally 60 minutes before induction. Group A & Group B received 1.5mg/kg of Esmolol IV as a loading dose over a period 5 minute just before induction of GA followed by 10?g/kg/min IV as a maintenance dose throughout the procedure. No hypnotic medication was given on the evening before surgery. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at (1) baseline, (2) 3 minutes after endotracheal intubation, (3) before pneumoperitoneum, (4) 15 minutes after pneumoperitoneum , (5) 30minutes after pneumoperitoneum, (6) 5 minutes after release of CO2 and (7) 5 minutes after extubation. Results: Both groups were similar with respect to demographic data. Clonidine group showed more stability in hemodynamic responses than Esmolol group in all hemodynamic variables. Conclusion: Oral Clonidine provides more stability than intravenous Esmolol in laparoscopic surgeries and also it is relatively safe and easy for oral administration with low cost.
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