A comparison of the hemodynamic responses to intravenously administered clonidine and magnesium sulphate during laparoscopic cholecystectomy

Abstract

Background: Hemodynamic response is considerable after laparoscopic procedures. Both magnesium and clonidine are known to reduce the hemodynamic response to pneumoperitoneum and block catecholamine and vasopressin production. The goal of this randomised, placebo-controlled trial is to determine which medication reduces the hemodynamic stress response to pneumoperitoneum the most effectively. Methods: Randomization was used to divide the 60 patients undergoing elective laparoscopic cholecystectomy into 3 groups of 20 each. Ten minutes before the development of pneumoperitoneum, the research medications were intravenously administered. Group M received 50mg/kg magnesium sulphate in 10 ml of normal saline, while group NS received 10 ml of normal saline. Group C received 1mcg/kg of clonidine in 10 ml of normal saline. Before induction (baseline value), after the study drug was administered, 5 minutes after the formation of the pneumoperitoneum, and then every 10 minutes after that. Results: Following pneumoperitoneum, the control group experienced a statistically significant increase in the mean heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and rate pressure product (NS). Both the Magnesium (M) and Clonidine (C) groups significantly reduced the hemodynamic response to pneumoperitoneum. However, the magnesium sulphate group experienced significantly longer extubation times and times to respond to spoken orders. None of the groups experienced any additional negative effects. Conclusion: With equivalent effectiveness, magnesium sulphate or clonidine administration reduces the hemodynamic response to pneumoperitoneum.