Purpose: Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. The pneumoperitoneum used for laparoscopic procedures leads to significant impairment of cardiopulmonary function. Clonidine has been shown to reduce perioperative haemodynamic instability. The aim of the study was to investigate the clinical efficiency of oral clonidine premedication in prevention of haemodynamic response associated with pneumoperitoneum.

 Methods: This randomized double blind study started with institute ethics committee approval. Sixty ASA 1 and ASA 2 patients undergoing elective laparoscopic cholecystectomy with no cardiovascular co–morbidity were enrolled for the study and received either tab clonidine 150 mcg [group C–30] or placebo drug Ranitidine [group P– 30] orally one hour before the induction. Heart rate, systolic blood pressure, diastolic pressure and mean arterial pressure were recorded. The data obtained was analyzed using student‘s–test, ANOVA and Chi–square test.

Results: There is significant rise in heart rate was observed following pneumoperitoneum in Group P as compared to Group C (99.23±14.02 Vs 81.26±8.40 bpm). Similarly, rise in systolic arterial pressure (143.63±19.60 Vs 119.6±10.06 mm Hg), diastolic arterial pressure (99.23±14.02 Vs 81.26±8.40 mm Hg) and mean arterial pressure (114.13±16.57 Vs 93.83±8.107 mm Hg) was more in Group P following pneumoperitoneum. Nitroglycerine drip was started in 33.3% patients in Group P to control intraoperative hypertension. Incidence of postoperative nausea–vomiting and shivering was also less in Group C.

Conclusion: From our study we found that oral clonidine 150mcg can effectively counteract the cardiovascular changes induced by pneumoperitoneum. , hence it can be recommended as a routine premedication for laparoscopic procedure