EFFECT OF MAGNESIUM SULFATE AND CLONIDINE IN ATTENUATING HEMODYNAMIC RESPONSE IN LAPAROSCOPIC CHOLECYSTECTOMY -A CLINICAL COMPARATIVE STUDY

Abstract

INTRODUCTION - Laryngoscopy and tracheal intubation invariably causes hypertension and tachycardia and subsequent pneumoperitoneum and changes in patient position required during laparoscopic surgeries add to the insult. In patients with cardiovascular co-morbididities, such alterations can cause severe life threatening situations 1 perioperatively .Various drugs have been tried to attenuate these effects and in this regard,clonidine,and magnesium sulfate have shown promising results. AIM- This study was aimed at comparing the efficacy of clonidine and magnesium sulphate in attenuating the hemodynamic responses to laryngoscopy, intubation and pneumoperitoneum, assessed in terms of heart rate, systolic blood pressure,diastolic blood pressure and mean arterial pressure. INCLUSION CRITERIA:Patients between age 18-60 years, of both sexes, ASA grade I&II and scheduled for elective laparoscopic cholecystectomy under general anesthesia. EXCLUSION CRITERIA:Refusal to informed consent,anticipated difficult airway,ASA grade III&IV,history of allergy to study drug, pregnant and lactating mother, any disorders of cardiovascular system, respiratory system, renal system, hepatic and neuromuscular condition. METHODS-:A randomized prospective study was conducted in Silchar Medical College and Hospital, Silchar, and 80 patients were randomly allocated to two groups of 40 patients each.One group received clonidine 1.5mcg/kg whereas other group received MgSO4 50mg/kg.HR,SBP,DBP,and MAP were recorded at baseline,after infusion of the study drug, just before intubation, after intubation at 1min,3mins,and5mins, after pneumoperitoneum at 5min,10min,20min,and 30min.All analyses were done by using two tailed test p-value. RESULTS: The mean values in HR,SBP, and MAP values at at various intervals were statistically significant (p<0.05) in clonidine group when compared to MGSO4 group. CONCLUSION: Clonidine was found more effective than MGSO4 during laryngoscopy and intubation while both were equally effective during pneumoperitoneum which correlated with other similar studies.