Oral Clonidine as Pre-Medication on Perioperative Haemodynamics, Sedation and Analgesia

Background: The current study was designed to investigate the efficacy of oral clonidine as pre-anesthetic medication on preoperative sedation, analgesia and hemodynamic stability in patients undergoing gynecological laparotomy.Methods: It was a prospective, randomized, double-blind, controlled trial conducted on sixty adult female patients of ASA physical status I and II, aged 18-40 years, undergoing gynecological laparotomy. Patients were randomized to receive either oral clonidine 2-2.5mcg/kg (30 patients) or placebo (30 patients). Endpoints of the study were hemodynamic status (measured as heart rate and blood pressure), level of sedation (measured by the Ramsay sedation score) and level of analgesia (measured as VAS score). Comparison of both groups was done by independent t-test or chi-square test as required.Results: Hemodynamic status was more stable in clonidine group. Fluctuation of heart rate and per-operative hypertension was less frequent in patients receiving clonidine compared to placebo. Moreover, clonidine showed better efficacy in preoperative sedation and postoperative analgesia compared to placebo (Ramsay sedation score was 2.0 vs 1.0 and VAS score was 4.9 vs 6.7 in clonidine group and placebo group respectively).Conclusion: Our findings suggest that oral clonidine (2-2.5mcg/kg) as pre-anesthetic medication is effective to produce pre operative sedation, stable hemodynamics and to facilitate postoperative analgesia in elective gynecological laparotomy cases.