Indian Journal of Clinical Anaesthesia


Effect of oral clonidine premedication on perioperative hemodynamic response - A randomized double blind placebo controlled study


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Author Details: Abhishek Bhuava, Akshaya N Shetti, Vinod Kharde, VK Badhe, Das Divekar

Volume : 3

Issue : 1

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 4

Article End Page : 11


Abstract

Introduction: Preanesthetic medication forms an integral part of anaesthetic management. Pharmacological and non-pharmacological techniques are tried to achieve anxiolysis and better hemodynamic stability. Clonidine is alpha 2 agonist and acts on central nervous sytem. It is adminstered in various route and oral route is one of them. This study has been designed to study the effect of oral clonidine on perioperative hemodynamics.
Aims: To evaluate beneficial effects of oral clonidine in attenuating the haemodynamic responses and comparing with placebo in patients undergoing surgeries under general anaesthesia.
Settings and Design: Randomized double blind study.
Methods and Material: Two hundred patients were enrolled in this study and studied for 2 years. Randomization was carried out. Four groups, including 50 patients per group were created. Group I (Placebo) received oral tablet ranitidine 150 mg, Group II C2, C3 and C4received oral clonidine 2 µg/kg, 3µg/kg and 4µg/kg body weight respectively. Sedation, anxiolysis and hemodynamic changes were recorded.
Statistical analysis used: The statistical significance for categorical variables was determined by chi-square test. For continuous variables two sample t-test was applied. For intra group comparison paired t- test and for inter group comparison unpaired t-test was used. Results were expressed as Mean ± SD (standard deviation). A P value < 0.05 was considered statistically significant.
Results: No statistically significant differences concerning demographic data between the groups of patients computed. A significant difference observed with respect to sedation and anxiolysis between all the four groups. The HR response between clonidine (2 µg/kg, 3µg/kg and 4µg/kg) and placebo was very significant at all times (p<0.001) showing a favorable response towards attenuation of HR. The SBP, MAP and DBP response between clonidine and placebo is significant at all times. When compared to clonidine (2 µg/kg, 3µg/kg and 4µg/kg) group the requirement of MAC of Isoflurane in placebo group is higher.
Conclusion: Administration of oral clonidine preferably 4µg/kg, as pre-medicant results in improved perioperative haemodynamic stability and Isoflurane sparing effect.

Key Words:
Anxiolysis, Clonidine, Hemodynamic response, Oral premedication.

Key Messages: Various methods are used to allay anxiety and good hemodynamic control in perioperative period. Pharmacological and non-pharmacological methods are popular. Spectrum of drugs have been tried to achieve these goals. Oral Clonidine is one of them. We studied different doses of oral clonidine and its effect during perioperative period