EVALUATION OF INJ. CLONIDINE IN MAINTAINING HAEMODYNAMICS DURING LAPAROSCOPIC OPERATIVE PROCEDURES

Pneumoperitoneum usually with CO2 insufflations created during laparoscopic operative procedures affects several homeostatic systems leading to adverse effects on cardiovascular and pulmonary physiology and produces stress response. There is increase in pulse rate, systolic blood pressure and decrease in cardiac output and increase in systemic vascular resistance. Clonidine an alpha(2) agonist with its central sympatholytic action attenuates the cardiovascular adverse effects and provide intraoperative as well as postoperative analgesia. In the present study, 60 ASA grade I and II of either sex between age range of 18-60 years and weight range of 45-70 kg were divided into 2 equal groups of 30 each. Group A served as control group A, received inj. Midazolam 0.03 mg/kg and inj. Pentazocine 0.3 mg/kg as premedication 15 minutes prior to induction of anaesthesia and group B received inj. Clonidine 1 mu gm/kg as premedication before induction of anaesthesia. Anaesthesia was induced with inj. Thiopentone 5 mg/kg and inj. Vecuronium 0.1 mg/kg in all patients. All patients were maintained on oxygen, nitrous oxide and inj. Propofol infusion on IPPV. Pneumoperitoneum was created with CO2 and intra-abdominal pressure was maintained on 15 mmHg. All patients were observed for changes in pulse rate, systolic blood pressure, EtCO2 throughout intraoperative period. Normocapnia was maintained. It was observed that Clonidine group provided statistically significant cardiovascular stability with less increase in pulse rate and systolic blood pressure. The requirement of additional analgesic drugs was minimum in Clonidine group with minimal sedation. Thus, it was concluded that premedication with inj. Clonidine in dose of 1 mu gm/kg prior to induction of anaesthesia provides effective cardiovascular stability and attenuates the increase in pulse rate, systolic blood pressure, decrease in cardiac output and increase in systemic vascular resistance secondary to sympathetic stimulation secondary to pneumoperitoneum during laparoscopic surgeries.