A Randomized Controlled Trial to Study the Effect of Intravenous Clonidine and Intravenous Fentanyl on Perioperative Hemodynamics during Laparoscopic Cholecyctetomy.

Peritoneal insufflation and laryngoscopy & intubation cause alteration of hemodynamics to a certain extent. The aim of this double blind, randomized controlled trial was to know and compare the effect of I.V. clonidine and I.V. fentanyl on hemodynamics during laparoscopic cholecystectomy in the department of Anaesthesia, Lady Hardinge Medical College, Delhi University, Delhi, India from November 2011 to April 2013. Eighty (80) patients (ASA I or II) posted for elective laparoscopic cholecystectomy were randomly allocated to two groups. Group C received I.V. Clonidine (2mcg/kg) and Group F received I.V. Fentanyl (2mcg/kg). Heart rate and Mean Blood Pressure were recorded as baseline (before study drug), after study drug, after I.V. induction, at intubation 0, 1, 3, 5 and 10 minutes after intubation, at start of pneumoperitoneum and thereafter every 15 minutes till the end of surgery. I.V. fentanyl and I.V. clonidine both were able to attenuate the perioperative hemodynamics response during laryngoscopy and intubation and also during pneumoperitoneum. In Group F there was insignificant rise and in Group C there was insignificant fall in MBP. The requirement of thiopentone and sevoflurane were significantly less, whereas duration of post operative analgesia was significantly prolonged in clonidine group as compared to fentanyl group. Post operatively, patients were well sedated and side effects like nausea, vomiting and shivering were less in clonidine group. I.V. fentanyl can be used to attenuate the hemodynamic response in normotensive patients whereas clonidine will be a better choice in hypertensive patients.