Effect of Oral Clonidine Premedication on Perioperative Hemodynamic Response and Postoperative Analgesic Requirement for Patients Undergoing Laparoscopic Cholecystectomy

以前膽性、單盲式隨機取樣方式，對於110名預備接受腹腔鏡切除膽囊之患者進行預先給予口服clonidine之研究探討。65名患者爲placebo group（口服alugel），另外45名爲clonidine group。所有患者在預定手術前60至90分鍾分別給予alugel或clonidine。麻醉方式與誘導藥物均相同。術中end-tidal CO2均維持在正常範圍內。我們評估手術中血行動力表現，isoflurane使用量及術後患者的止痛效果與副作用，發現預先口服clonidine者術中血壓、心跳表現穩定，isoflurane使用量降低30%，並且術後24小時內止痛劑需求量較服用alugel者少(1.5±1.3 vs. 2.2±1.3次；P＜0.05)：術後副作用亦鮮少發生。我們認爲預先口服clonidine，對於腹腔鏡切除膽囊之患者，可增加麻醉安全，並給予患者安全平穩的恢復。

關鍵字

Clonidine ；腹腔鏡膽囊切除術；術後疼痛

並列摘要

Background: To investigate the clinical efficacy of oral clonidine premedication in anesthesia and analgesia in patients undergoing laparoscopic cholecystectomy (LC). Methods: One hundred and ten patients, scheduled for elective laparoscopic cholecystectomy, were recruited for the prospective, randomized, single-blind, comparative study. They were randomly allotted to either of the placebo or clonidine group. Patients of the placebo group (n=65) were premedicated with oral antacid (alugel hydroxide 300 mg), while those in the clonidine group (n=45) were premedicated with oral clonidine 150 μg prior to anesthesia. The premedication was given 60 to 90 min before the anticipated time of induction of anesthesia. Normocapnia was maintained throughout the perioperative period. Mass spectrometer was used to assess the inspired and expiratory concentrations of isoflurane, the anesthetic used for maintenance of anesthesia. Postoperative pain intensity, sedation scores, adverse events, time to the fiist dose of postoperative analgesic and cumulative analgesic requirement in 24 hours were recorded. Data were expressed as mean±SD. Results: Patients in the clonidine group displayed greater hemodynamic stability perioperatively and the isoflurane requirement was also reduced (30% less). The postoperative analgesic requirement was less (1.5±1.3 vs 2.2±1.3 dose, P＜0.05) and the time for the first dose of analgesic was prolonged (411±565 vs. 264±441 min) in comparison with the placebo group but no statistic difference was found. Conclusions: Oral clonidine premedication helped to provide perioperative hemodynamic stability, spared the use of isoflurane and reduced the requirement of postoperative analgesia so as to smoother the way to recovery in patients undergoing LC.

並列關鍵字

Clonidine ； Cholecystectomy, laparoscopic ； Pain, postoperative

國際替代計量

Effect of Oral Clonidine Premedication on Perioperative Hemodynamic Response and Postoperative Analgesic Requirement for Patients Undergoing Laparoscopic Cholecystectomy

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