Further Discussion on Intravenous Clonidine and Magnesium Sulphate in Laparoscopic Cholecystectomy: A Response to Recent Queries

Dear Editor, We sincerely thank the authors for their comments on our article, “Rymbai, Sharon Aylmer Lamare; Hazra, Darpanarayan. Intravenous Clonidine and Magnesium Sulphate in Attenuating Hemodynamic Response to Pneumoperitoneum During Laparoscopic Cholecystectomy: A Randomized Blinded Comparative Study,” published in the Medical Journal of Dr. D.Y. Patil Vidyapeeth (17(2): 286–291, March-April 2024|DOI: 10.4103/mjdrdypu.mjdrdypu_629_22).[1] We are addressing their questions to the best of our abilities. You correctly noted the importance of controlling the sympathetic response to pneumoperitoneum to minimize morbidity in laparoscopic surgeries. Managing this with minimal side effects from the drugs and ensuring rapid recovery from anesthesia are crucial for optimal outcomes. Our study aimed to compare the effects of intravenously administered Clonidine and MgSO4 on hemodynamic responses during pneumoperitoneum and to observe any adverse effects.[1] The literature shows conflicting data on Clonidine’s superiority over MgSO4 and vice versa.[2-4] Various drugs, including Esmolol, Ropivacaine, Clonidine, Magnesium Sulphate, and Dexmedetomidine, have been investigated for this purpose, but the results remain inconclusive.[3,5-8] Our study is a contribution to this ongoing research. Our primary goal was to compare the effects of intravenous Clonidine and MgSO4 on hemodynamic responses during pneumoperitoneum and assess any adverse effects. Our findings showed no significant differences in systolic blood pressure, mean arterial pressure, heart rate, or oxygen saturation between the two groups. Both drugs provided similar levels of sedation with minimal and comparable adverse effects. We acknowledge the importance of cost analysis in evaluating the overall efficacy and practicality of these treatments. Therefore, we plan to conduct a further prospective study to examine and compare the costs associated with Clonidine and MgSO4 administration, providing more comprehensive insights for informed recommendations based on clinical and economic considerations. You are absolutely right, and we regret the oversight. This study was a prospective, randomized, blinded trial conducted over six “months,” comparing the efficacy of Clonidine (1.5 μg/kg—Group A) and Magnesium Sulphate (MgSO4) (50 mg/kg—Group B). We sincerely thank the authors for their feedback. Our study compared intravenous Clonidine and MgSO‚„ for managing hemodynamic responses during pneumoperitoneum and found no significant differences between the two in terms of hemodynamic parameters or adverse effects. Recognizing the importance of cost-effectiveness, we plan to conduct further research to evaluate and compare the costs associated with Clonidine and MgSO‚„. We appreciate the opportunity to clarify these points and look forward to contributing further to this field. Data availability statement The data supporting the findings of this study can be made available upon reasonable request. Access to the data will be granted after proper verification and approval, ensuring compliance with relevant ethical guidelines and institutional policies. Author contribution DH: Definition of intellectual content, literature search, manuscript preparation and revision. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.