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CC BY-NC-ND 4.0 · Avicenna J Med 2015; 05(03): 67-73
DOI: 10.4103/2231-0770.160231
ORIGINAL ARTICLE

Effects of dexmedetomidine and clonidine as propofol adjuvants on intra-operative hemodynamics and recovery profiles in patients undergoing laparoscopic cholecystectomy: A prospective randomized comparative study

Naz Anjum
Department of Anaesthesiology and Intensive Care, R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India
,
Hussain Tabish
Department of Functional Genomics, Institute of Genomics and Integrative Biology, New Delhi, India
,
Saha Debdas
Department of Anaesthesia and Critical Care, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
,
Hembrom P Bani
Department of Anaesthesiology and Intensive Care, R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India
,
Choudhuri Rajat
Department of Anaesthesiology and Intensive Care, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
,
Ghosh Dastidar Anjana Basu
Department of Anaesthesiology and Intensive Care, R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Context: Alpha-2 (α2) adrenergic receptor agonists, clonidine and dexmedetomidine, are widely used as adjuvants during anesthesia for analgesic, sedative, sympatholytic, and cardiovascular stabilizing effects. Aims: We compared effects of clonidine and dexmedetomidine (as propofol adjuvants) on intra-operative hemodynamics, recovery time, and postoperative cognitive function impairment. Subjects and Methods: Forty-five American Society of Anesthesiologists I and II patients, scheduled for laparoscopic cholecystectomy were divided into three groups (n = 15). Group C patients received bolus of clonidine 3 μg/kg followed by a continuous infusion; Group D patients received dexemedetomidine 1 μg/kg and a continuous infusion; and Group P patients received a bolus of normal saline followed by an infusion. Intra-operative mean arterial pressure (MAP) and pulse rate (PR) were measured throughout the surgery. Bispectral index was maintained at 55 ΁ 5 by titrating propofol infusion rate. The time between the interruption of anesthesia and eye opening (recovery time) was measured. Cognitive function was assessed using short mental status questionnaire at 15, 30, 45, and 60 min postoperatively. Results: The sympathetic response to laryngoscopy and extubation on MAP and PR were significantly reduced with the use of clonidine and dexmedetomidine (P < 0.05). The recovery was delayed (P < 0.05) with both the drug combinations and it was more pronounced with dexmedetomidine (P < 0.05). Dexmedetomidine group showed cognitive impairment in a postoperative period lasting up to an hour. Conclusions: When co-administered with propofol, both clonidine, and dexmedetomidine attenuate sympathetic response to laryngoscopy and extubation but cause delay in the recovery from anesthesia. Dexmedetomidine causes impairment of postoperative cognitive functions.

Keywords

Clonidine - cognitive dysfunction - dexmedetomidine - hemodynamics - recovery time


Publication History

Article published online:
09 August 2021

© 2015. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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