Year :
2021
| Month :
October
| Volume :
15
| Issue :
10
| Page :
UC14 - UC18
Full Version
Effects of Intravenous Dexmedetomidine and Clonidine on Haemodynamic Response in Laparoscopic Lower Abdominal Oncosurgeries under General Anaesthesia: A Randomised Controlled Trial
Published: October 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/51719.15566
Prashant Hatti, HS Mamatha, Mallikarjuna, Shashidhar Gowdra Sugandharajappa, VB Gowda
1. Senior resident, Department of Anaesthesia, VTSM Peripheral Cancer Center, Branch of KMIO, Kalaburagi, Karnataka, India.
2. Assistant Professor, Department of Anaesthesia, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
3. Assistant Professor, Department of Anaesthesia, VTSM Peripheral Cancer Center, Branch of KMIO, Kalaburagi, Karnataka, India.
4. Associate Professor, Department of Anaesthesia, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
5. Professor and Head, Department of Anaesthesia, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
Correspondence Address :
Dr. Shashidhar Gowdra Sugandharajappa,
Associate Professor, Department of Anaesthesia, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
E-mail: drshashi_2007@yahoo.co.in
Abstract
Introduction: From the early 1970's, laparoscopic procedures became well established because of their advantages like excellent visualisation, improved cosmesis, reduced postoperative pain and reduced hospital stay. Despite its advantages, laparoscopic surgeries have its demerits such as pneumoperitoneum and positional changes. Alpha-2 agonists have shown promising results in attenuating the stress response in laparoscopic surgeries.
Aim: To compare clonidine and dexmedetomidine in attenuating haemodynamic stress response during laparoscopic lower abdominal oncosurgeries.
Materials and Methods: A randomised controlled trial was conducted at Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India, during the period of December 2018 to May 2019. Institutional Ethical Committee clearance was obtained for the trial. Total 48 patients were recruited into two groups with 24 participants in each group: A (clonidine) and B (dexmedetomidine). Both drugs were infused at a dose of 1 μg/kg for 15 minutes along with premedication before induction. Haemodynamic stress response was estimated using parameters like Heart Rate (HR), systolic and diastolic blood pressure and mean arterial pressure at induction, pneumoperitoneum and at extubation. All the data were analysed using the statistical software R (V3.6.2). Continuous data were presented in the form of Mean±Standard Deviation (SD). The difference in mean value of the various parameters between the two groups was analysed using Student’s t-test. A p-value of <0.05 was considered to be significant.
Results: Patients in both the groups were comparable with regards to demographic features. The mean age was 46.76±8.17 years, 46.24±9.70 years and weight was 55.76±7.28 and 56.08±6.06 for group A and group B, respectively. There were statistically significant differences in attenuating stress response in dexmedetomidine compared to clonidine group. Statistically significant reduction in the HR was noticed in group B as compared to group A at 12 minutes of infusion (p=0.008), at the end of infusion (p=0.008), before intubation (p=0.005), 10 minutes after intubation (p=0.008) and after pneumoperitoneum (p=0.045). Group B which was given dexmedetomidine drug compared to group A with clonidine drug showed better attenuation of the systolic blood pressure during extubation (p=0.006).
Conclusion:To conclude, both clonidine and dexmedetomidine effectively attenuate the haemodynamic response in patients undergoing laparoscopic lower abdominal oncosurgeries when administered as intravenous bolus dose. In addition, the dexmedetomidine attenuates haemodynamic responses better than clonidine.
Keywords
Alpha-2 agonists, Extubation, Intubation, Pneumoperitoneum
10.7860/JCDR/2021/51719.15566
Date of Submission: Aug 04, 2021
Date of Peer Review: Aug 28, 2021
Date of Acceptance: Sep 27, 2021
Date of Publishing: Oct 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 05, 2021
• Manual Googling: Sep 24, 2021
• iThenticate Software: Aug 27, 2021 (17%)
ETYMOLOGY: Author Origin
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