Gupta Kumkum, Lakhanpal Mahima, Gupta Prashant K, Krishan Atul, Rastogi Bhawna, Tiwari Vaibhav
Department of Anaesthesiology and Critical Care, N.S.C.B. Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.
Department of Radio diagnosis, Imaging and Interventional Radiology, N.S.C.B. Subharti Medical College, Swami Vivekananda Subharti University, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.
Anesth Essays Res. 2013 Jan-Apr;7(1):29-33. doi: 10.4103/0259-1162.113984.
Laparoscopic cholecystectomy under general anesthesia induced intraoperative hemodynamic responses which should be attenuated by appropriate premedication. The present study was aimed to compare the clinical efficacy of clonidine and fentanyl premedication during laparoscopic cholecystectomy for attenuation of hemodynamic responses with postoperative recovery outcome.
In this prospective randomized double blind study 64 adult consented patients of either sex with ASA I and II, scheduled for elective laparoscopic cholecystectomy under general anesthesia and met the inclusion criteria, were allocated into two groups of 32 patients. Group C patients have received intravenous clonidine 1μg kg(-1) and Group F patients have received intravenous fentanyl 2μg kg(-1) 5 min before induction. Anesthetic and surgical techniques were standardized. All patients were assessed for intraoperative hemodynamic changes at specific time and postoperative recovery outcome.
Premedication with clonidine or fentanyl has attenuated the hemodynamic responses of laryngoscopy and laparoscopy. Clonidine was superior to fentanyl for intraoperative hemodynamic stability. No significant differences in the postoperative recovery outcome were observed between the groups. Nausea, vomiting, shivering and respiratory depression were comparable between groups.
Premedication with clonidine or fentanyl has effectively attenuated the intraoperative hemodynamic responses of laparoscopic cholecystectomy.
全身麻醉下的腹腔镜胆囊切除术会引发术中血流动力学反应,适当的术前用药应能减轻这种反应。本研究旨在比较可乐定和芬太尼术前用药在腹腔镜胆囊切除术中减轻血流动力学反应及术后恢复情况方面的临床疗效。
在这项前瞻性随机双盲研究中,64例年龄≥18岁、美国麻醉医师协会(ASA)分级为Ⅰ或Ⅱ级、自愿接受全身麻醉下择期腹腔镜胆囊切除术且符合纳入标准的成年患者被随机分为两组,每组32例。C组患者在诱导前5分钟静脉注射可乐定1μg/kg,F组患者在诱导前5分钟静脉注射芬太尼2μg/kg。麻醉和手术技术标准化。所有患者均在特定时间评估术中血流动力学变化及术后恢复情况。
可乐定或芬太尼术前用药均减轻了喉镜检查和腹腔镜检查时的血流动力学反应。可乐定在维持术中血流动力学稳定方面优于芬太尼。两组术后恢复情况无显著差异。两组恶心、呕吐、寒战和呼吸抑制的发生率相当。
可乐定或芬太尼术前用药均能有效减轻腹腔镜胆囊切除术的术中血流动力学反应。