A Comparative Study to Assess the Effectiveness of Intrathecal Clonidine Alone Versus Clonidine Combined with Fentanyl for Laparoscopic Surgeries Under General Anesthesia

Abstract

Background: Laparoscopic surgeries, although minimally invasive, can lead to hemodynamic changes due to the creation of pneumoperitoneum [1], [2]. Several research studies have been conducted to reduce these hemodynamic effects during laparoscopic procedures. Material and methods: A randomized, double-blind study was conducted involving 40 patients of both genders, with American Society of Anesthesiologists Grade I and II classifications, aged between 20 and 50 years, who were scheduled for laparoscopic surgeries. In this study, Group CL (comprising 20 patients) received an intrathecal dose of 140 micrograms of clonidine, while Group CF (also with 20 patients) received intrathecal clonidine at a dosage of 70 micrograms followed by intrathecal fentanyl at 25 micrograms before the administration of general anesthesia. The evaluation parameters encompassed hemodynamic measurements, postoperative pain relief, and sedation scores. Results: During the surgical procedure, Group CL exhibited a noteworthy decrease in intraoperative heart rate, as well as systolic, diastolic, and mean arterial blood pressures at intubation, during pneumoperitoneum, and at extubation when compared to Group CF (p < 0.05) [3]. Additionally, the average duration of postoperative pain relief was significantly longer in Group CL (10.20

± 1.24 hours, p < 0.001) compared to Group CF (5.23 ± 1.11 hours). Furthermore, Group CL had a notably higher mean sedation score (2.06 ± 0.25) compared to Group CF (1.90 ± 0.31; p = 0.025). Importantly, no adverse effects were reported during the study. Conclusion: The administration of intrathecal clonidine at a dosage of 150 micrograms has demonstrated remarkable efficacy in preserving stable intraoperative hemodynamics in the context of laparoscopic surgeries performed under general anesthesia. Furthermore, this approach offers extended postoperative pain relief when compared to the combination of intrathecal clonidine at 70 micrograms with fentanyl at 20 micrograms.