A Dose Response Study Of Oral clonidine as premedication in patients undergoing abdominal gynaecological surgery

Abstract

Background: The current study was designed to investigate the safe and effective dose of oral clonidine onpost-operative analgesia in patients undergoing gynaecological laparotomy. The objective of the study was to see theeffectiveness of oral Clonidine as a preanesthetic medication and to determine which dose of oral Clonidine givesbetter analgesic effect. Method: In this prospective, randomized, double-blind, controlled study sixty adult female patients of ASA physicalstatus I & II aged 18-40 yrs, undergoing gynaecological laparotomy received low dose clonidine 2-2.5mcg/kg (n=30)and high dose clonidine 4-4.5mcg/kg (n=30).These drugs were administered 105 min before the estimated time ofinduction of anesthesia. Heart rate & arterial pressure were recorded prior to induction, 5 min intervally upto 20 minin peroperative time and 2 hour intervally upto 6 hours in postoperative period. In the Group-A (clonidine2-2.5mcg/kg) mean heart rate ranged from73.80 ±8.69 to 71.45±5.80, in Group-B mean heart rate decreased morefrom 70.85±7.64 to 67.85±6.47. Systolic blood pressure in Group-A (low dose clonidine) was 113.00±7.32, inGroup-B (high dose clonidine) was 120.00±10.38 and where p=0.024. Diastolic blood pressure of Group-A (low doseclonidine) was 76.15±5.29, in Group-B(high dose clonidine) was 80.10±5.3. Postoperative pain was assessed by ablinded observer using a VAS scale. This study was done in the department of anesthesiology of Apollo HospitalsDhaka over a period of six months. Results: Patients in group A (low dose) and group B (high dose) showed no significant hemodynamic changesbetween groups. Five patients in group B showed marked hypotension and bradycardia and treatedaccordingly.Group B patients (high dose clonidine) showed more post operative analgesia compared to group A. Conclusion: These data suggest that low dose clonidine (100mcg/kg) premedication is safe and effective to facilitatepost-operative analgesia with stable haemodynamics & without any side effects. On the other hand,.high doseclonidine showed more post op analgesia &.marked hypotension and bradycardia. JBSA 2022; 35 (2) : 12-16