Comparative Study of Clonidine versus Dexmedetomidine for Hemodynamic Stability during Laparoscopic Cholecystectomy

Background: Alpha-2 adrenergic agonists clonidine and dexmedetomidine, are well-known to attenuate hemodynamic stress response in laparoscopic surgeries. Aims and Objective: The aim of this study is to compare the effectiveness of intravenously administered clonidine versus dexmedetomidine to attenuate hemodynamic responses to pneumoperitoneum (PP) during laparoscopic cholecystectomy under general anesthesia. Materials and Methods: A total of 60 patients (age 25-50 years) undergoing elective laparoscopic cholecystectomy surgery under general anesthesia were assigned randomly to one of two groups: Group-C (clonidine group) received clonidine 1 mu g/kg in normal saline and Group D (dexmedetomidine group) received dexmedetomidine 1 mu g/kg in normal saline intravenously. Total volume of the study drug was adjusted to 50 ml and administered over a period of 15 min before induction. Results: Mean heart rate was low for Group D. Four out of 29 patients (15%) in Group D required intravenous atropine due to bradycardia. Systolic arterial pressure was significantly lower in Group D, especially after intubation, at P30 and after extubation. No significant episode of hypotension was found in any of the groups post PP. None of the patient showed any evidence of ischemia or arrthymia intraoperatively. Conclusion: Dexmedetomidine was more effective in attenuating hemodynamic response to PP when compared with clonidine. However, with dexmedetomidine there are greater chances of developing hypotension and bradycardia.