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Vpliv intravenske premedikacije s klonidinom na hemodinamski stresni odgovor in porabo fentanila pri laparoskopskih odstranitvah žolčnika = The influence of intravenous premedication with clonidine on haemodynamic stress response and fentanyl dosage during laparoscopic cholecystectomy
Novak-Jankovič, Vesna ; Požar-Lukanovič, Neva
Background. Induction of CO2 pneumoperitoneum in laparoscopic procedures increases sympathetic nervous activity, which may lead to tachycardia and hypertension. Numerous investigations have shown ...that clonidine, an alpha2 adrenergic agonist, reduces adrenergic haemodynamic response to surgical stimulation. The aim of this study was evaluate the role of clonidine premedication used with peritoneal CO2 insufflation in preventing hypertensionand tachycardia, and in reducing fentanyl dosage during laparoscopic cholecystectomy. Patients and methods. Sixty ASA I-III patients, planned for laparoscopic cholecystectomy, were randomly assigned to either a clonidine or control group. The study group was premedicated with clonidine (4mikro g/kg b.w.), given in an infusion 15 min before inducing anaesthesia. Standard anaesthesia administration and intraoperative monitoring were used inboth groups. Differences in blood pressure, heart rate and fentanyl consumption between the groups were determined. Results. There were no differences in demographic parameters between the groups. Hypertension of > 180 mm Hg occurred in none of the clonidine patiemts but in 16 per cent of thecontrols (p<0,05). Systolic, men and diastolic blood pressures determined after pneumoperitoneum induction and at the end of the operation were significantly lower in the clonidine group relative to the control group (p4=0.02, p5=0.02). The difference between the groups concerning the decrease of heart rate below 50 beats/min was not statistically significant. The consumption of fentanyl was significantly lesser in the clonidine group than in the controls (4,8 mikro g/kgbw/min vs 2.9 mikro g/kgbw/min, p<0.003). (Abstract truncated at 2000 characters).
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