Oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation
- PMID: 21804800
- PMCID: PMC3139312
- DOI: 10.4103/1658-354X.82791
Oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy: A comparative evaluation
Abstract
Background: Hemodynamic responses of laryngoscopy and laparoscopy should be attenuated by the appropriate premedication, smooth induction, and rapid intubation. The present study evaluated the clinical efficacy of oral premedication with pregabalin or clonidine for hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy.
Methods: A total of 180 healthy adult consented patients aged 35 to 52 years with American Society of Anesthesiologist (ASA) physical status I and II of both gender, who met the inclusion criteria for elective laparoscopic cholecystectomy, were randomized to receive placebo Group I, pregabalin (150 mg) Group II, or clonidine (200 μg) Group III, given 75 to 90 minutes before surgery as oral premedication. All groups were compared for preoperative sedation and anxiety level along with changes of heart rate and mean arterial pressure prior to premedication, before induction, after laryngoscopy, pneumoperitoneum, release of carbon dioxide, and extubation. Intraoperative analgesic drug requirement and any postoperative complications were also recorded.
Results: Pregabalin and clonidine proved to have sedative and anxiolytic effects as oral premedicants and decreased the need of intraoperative analgesic drug requirement. Clonidine was superior to pregabalin for attenuation of the hemodynamic responses to laryngoscopy and laparoscopy, but it increased the incidence of intra-and postoperative bradycardia. No significant differences in the parameters of recovery were observed between the groups. None of the premedicated patient has suffered from any postoperative side effects.
Conclusion: Oral premedication with pregabalin 150 mg or clonidine 200 μg causes sedation and anxiolysis with hemodynamic stability during laryngoscopy and laparoscopic cholecystectomy, without prolongation of recovery time and side effects.
Keywords: Clonidine; hemodynamic response; laparoscopic cholecystectomy; laryngoscopy; pneumoperitoneum; pregabalin.
Conflict of interest statement
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References
-
- Reid LC, Brace DE. Irritation of the respiratory tract and its reflex effect upon heart. Surg Gynae Obstet. 1940;70:157–62.
-
- Stoelting RK. Circulatory changes during direct laryngosocpy and tracheal intubation- influence of duration of laryngoscopy with or without prior lidocaine. Anesthesiology. 1977;47:381–4. - PubMed
-
- Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine response to laryngoscopy with and without tracheal intubation. Br J Anesth. 1987;59:295–9. - PubMed
-
- Hassan HG, El-Sharkawy, Renk H, Mansour G, Fouda A. Hemodynamic and catecholamine stress responses to laryngoscopy with Vs without endotracheal intubation. Acta Anaesthesiology Scand. 1991;35:442–7. - PubMed
-
- Aronson S, Fontes ML. Hypertension: A new look at an old problem. Curr opin Anesth. 2006;19:59–64. - PubMed
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