International Journal of Health and Clinical Research
Yazarlar: Kushal Jethani, Vinay Gangwani, Sheetal Khandekar
Konular:-
Anahtar Kelimeler:Hemodynamic responses,Clonidine,Lignocaine,Laparoscopic cholecystectomy
Özet: Background: Laparoscopic cholecystectomy is associated with hemodynamic stress responses both during endotracheal intubation and due to creation of pneumoperitoneum. This stress response is of great concern in hypertensive and geriatric population. Aim: Comparison between Clonidine and Lignocaine in terms of attenuation of hemodynamic response occurring due to Intubation and due to creation of Pneumoperitoneum during Laparoscopic Cholecystectomy. Subjects and Methods: This prospective, randomized, double blinded controlled study was conducted on eighty subjects of ASA Grade I and II undergoing elective laparoscopic cholecystectomy. Patients were allocated into two groups, Group C receiving clonidine and Group L receiving lignocaine. Baseline clinical parameters were recorded. All patients received clonidine or lignocaine as a bolus before induction as well as continuous intravenous infusion throughout the surgical procedure. The dose of clonidine given was 2.25 μg/kg bolus and 1.2 μg/kg/hr infusion while that of lignocaine was 1.5 mg/kg bolus and 0.8 mg/kg/hr infusion. The patients were mechanically ventilated to keep EtCO2 between 35 and 40 mm Hg. Heart rate, Systolic blood pressure and diastolic blood pressure were recorded before induction and at 1 min, 3 min, 10 min, 30 min, 60 min and 90 min after intubation. Any adverse effect like hypotension, bradycardia, sedation or shivering were noted and compared. Results: In comparison to Lignocaine group; attenuation of heart rate, Systolic blood pressure(SBP) and diastolic blood pressure (DBP) were significantly more in Clonidine group (p<0.05). There was no significant difference in sedation score between the two groups. Conclusion: Clonidine was found to be more effective than lignocaine in attenuating the hemodynamic response occurring both due to laryngoscopy and due to creation of pneumoperitoneum in laparoscopic cholecystectomy.