Effect of Oral Clonidine and Gabapentin as Premedication on Intraoperative Hemodynamic Responses and Postoperative Analgesia Requirement in Laparoscopic Cholecystectomy

Megha Tyagi, Arvinpreet Kour, Ajaydeep Singh, Ritu Gupta, Ramnandan Prasad
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Abstract

Laparoscopic cholecystectomy pain is a sensory and emotional experience connected with actual or potential tissue damage. Effective pain control is quite important, with around 70% of patients still complaining of moderate-to-severe pain postoperatively. Uncontrolled perioperative pain may raise patient morbidity and mortality rates. Both gabapentin and clonidine as premeditated can be easily administered have minimal side effects, are easily available at a low price, both them have a sedative effect that can decrease anxiety and they can blunt the stress response. Moreover, both drugs have anti-nociceptive effects that may be beneficial for controlling postoperating pain which is the basis of our current study. This study aims to compare the efficacy of oral clonidine with gabapentin before induction of anesthesia in attenuating hemodynamic stress response to laryngoscopy, intubation, and carbon dioxide pneumoperitoneum in laparoscopic cholecystectomy and to compare the efficacy of oral clonidine with oral gabapentin for postoperative pain control. Hundred patients undergoing laparoscopic surgery and qualifying inclusion criteria were randomly allocated into two groups each containing 50 patients. Group I patients were given Tab. Clonidine (300 μg) and Group II patients were given tablet Gabapentin (600 mg) orally 60 min before induction of general anesthesia. Hemodynamic changes and the incidence of postoperative pain in both groups were measured and compared. Hemodynamic blunting to pressor stress of laryngoscopy and intubation was seen in both groups with better results obtained in the group receiving clonidine in the form of lesser variations in heart rate, systolic blood pressure, and diastolic blood pressure. Postoperative analgesia was achieved in both groups but gabapentin showed a better analgesic profile in the form of lesser Visual Analog Scale scoring and decreased utilization of rescue analgesia. Clonidine (300 μg) cause a greater attenuation of intraoperative hemodynamic stress responses, whereas gabapentin (600 mg) provides superior postoperative analgesia.
口服可乐定和加巴喷丁对腹腔镜胆囊切除术术中血流动力学反应和术后镇痛需求的影响
腹腔镜胆囊切除术疼痛是一种与实际或潜在组织损伤相关的感觉和情感体验。有效的疼痛控制非常重要,大约70%的患者术后仍抱怨中度至重度疼痛。围手术期疼痛失控可能会提高患者的发病率和死亡率。加巴喷丁和可乐定都可以很容易地预先给药,副作用最小,价格低廉,都有镇静作用,可以减少焦虑,并可以减弱压力反应。此外,这两种药物都具有抗伤害性作用,可能有利于控制术后疼痛,这是我们目前研究的基础。本研究旨在比较麻醉诱导前口服可乐定和加巴喷丁在减轻腹腔镜胆囊切除术中喉镜、插管和二氧化碳气腹的血液动力学应激反应方面的疗效,并比较口服可乐丁和口服加巴喷汀在术后疼痛控制方面的疗效。100名接受腹腔镜手术并符合入选标准的患者被随机分为两组,每组50名患者。I组患者在全麻诱导前60min口服可乐定(300μg),II组患者口服加巴喷丁片(600mg)。测量并比较两组患者的血液动力学变化和术后疼痛发生率。两组患者均观察到喉镜检查和插管对压迫压力的血液动力学减弱,接受可乐定治疗的患者获得了更好的结果,心率、收缩压和舒张压变化较小。两组均实现了术后镇痛,但加巴喷丁表现出更好的镇痛效果,表现为视觉模拟量表评分较低,抢救镇痛的利用率较低。可乐定(300μg)可使术中血液动力学应激反应减弱,而加巴喷丁(600 mg)可提供卓越的术后镇痛效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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