A Comparative Study between IV Clonidine 1.5Mcg/Kg and IV Lignocaine 1.5 Mg/Kg as Premedication for Attenuation of Hemodynamic Responses to Pneumoperitoneum in Laparoscopic Surgeries

Abstract

Laparoscopy, has emerged as the main stay for most of the commonly performed surgeries. Pneumoperitoneum and different positions of the patient during laparoscopy contribute to adverse cardiovascular effects like elevated arterial pressure, increased systemic and pulmonary vascular resistance and reduced cardiac output. This randomised controlled double blind prospective study was conducted to compare the efficacy of intravenous(I.V) Lidocaine and I.V. Clonidine in providing hemodynamic stability in patients undergoing laparoscopic surgeries. Methods: Seventy five adult patients of ASA grade 1 and 2, scheduled for elective laparoscopic surgery with a mean duration of 30- 90 minutes, were randomly allocated to one of the three groups. Group A: Clonidine group (n=25) - received injection Clonidine 1.5 mcg/kg 15 minutes prior to induction of anaesthesia. Group B: Lidocaine group (n=25) - injection Lidocaine 1.5 mg/kg 90 seconds prior to induction of anaesthesia. Group C: Control group (n=25) - received 10 ml normal saline intravenously. Results: There is no statistically significant difference between lidocaine and control group regarding mean HR, SBP, DBP, MAP during the entire period of pneumoperitoneum. Whereas, there is significant increase of blood pressures (SBP, DBP, MAP) in the lidocaine and control groups compared to the clonidine group from intubation, throughout the period of pneumoperitoneum. Clonidine also decreases the requirement of propofol for induction. Conclusion: I.V Clonidine 1.5mcg/kg premedication is more effective than Lidocaine 1.5mg/kg at preventing changes in hemodynamic parameters induced by carbondioxide pneumoperitoneum. Keywords: Pneumoperitoneum, I.V Clonidine, I.V Lignocaine, Hemodynamic parameters.