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

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 intr...

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Autores principales:	Naz Anjum, Hussain Tabish, Saha Debdas, Hembrom P Bani, Choudhuri Rajat, Ghosh Dastidar Anjana Basu
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2015
Materias:	clonidine cognitive dysfunction dexmedetomidine hemodynamics recovery time Medicine R
Acceso en línea:	https://doaj.org/article/35567fb31f4147bf88de549c5fd6a4ad
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spelling	oai:doaj.org-article:35567fb31f4147bf88de549c5fd6a4ad2021-12-02T16:24:57ZEffects of dexmedetomidine and clonidine as propofol adjuvants on intra-operative hemodynamics and recovery profiles in patients undergoing laparoscopic cholecystectomy: A prospective randomized comparative study2231-07702249-446410.4103/2231-0770.160231https://doaj.org/article/35567fb31f4147bf88de549c5fd6a4ad2015-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.160231https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Context: 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.Naz AnjumHussain TabishSaha DebdasHembrom P BaniChoudhuri RajatGhosh Dastidar Anjana BasuThieme Medical and Scientific Publishers Pvt. Ltd.articleclonidinecognitive dysfunctiondexmedetomidinehemodynamicsrecovery timeMedicineRENAvicenna Journal of Medicine, Vol 05, Iss 03, Pp 67-73 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	clonidine cognitive dysfunction dexmedetomidine hemodynamics recovery time Medicine R
spellingShingle	clonidine cognitive dysfunction dexmedetomidine hemodynamics recovery time Medicine R Naz Anjum Hussain Tabish Saha Debdas Hembrom P Bani Choudhuri Rajat Ghosh Dastidar Anjana Basu 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
description	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.
format	article
author	Naz Anjum Hussain Tabish Saha Debdas Hembrom P Bani Choudhuri Rajat Ghosh Dastidar Anjana Basu
author_facet	Naz Anjum Hussain Tabish Saha Debdas Hembrom P Bani Choudhuri Rajat Ghosh Dastidar Anjana Basu
author_sort	Naz Anjum
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2015
url	https://doaj.org/article/35567fb31f4147bf88de549c5fd6a4ad
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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

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