title: Effect of Magnesium Sulfate and Clonidine in Attenuating Hemodynamic Response to Pneumoperitoneum in Laparoscopic Cholecystectomy.
abstract: BACKGROUND
  Pneumoperitoneum in laparoscopic procedures is associated with hemodynamic response, due to the release of catecholamines and vasopressin. Magnesium and clonidine have been used to attenuate such hemodynamic responses by inhibiting release of these mediators. We conducted this randomized, double-blinded study to assess which of the two attenuates hemodynamic response better.
  
  
  METHODS
  Ninety American Society of Anesthesiologists health status Classes I and II patients posted for elective laparoscopic cholecystectomy were randomized into three groups of thirty patients each. Group C received injection clonidine 1 μg/kg diluted in 10 mL normal saline over 10 min, prior to pneumoperitoneum. Group M received injection magnesium sulfate 50 mg/kg diluted in 10 mL normal saline over 10 min, prior to pneumoperitoneum. Group NS received 10 mL normal saline intravenously over 10 min, prior to pneumoperitoneum. Hemodynamic parameters were recorded before induction (baseline values), at the end of magnesium sulfate/clonidine/saline administration and before pneumoperitoneum (P0), 5 min (P5), 10 min (P10), 20 min (P20), 30 min (P30), and 40 min (P40) after pneumoperitoneum.
  
  
  RESULTS
  Systolic blood pressure, diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were all significantly higher in the normal saline group compared to magnesium and clonidine. On comparing patients in Group M and Group C, DBP, MAP, and HR were significantly lower in the magnesium group. Mean extubation time and time to response to verbal commands were significantly longer in the magnesium group.
  
  
  CONCLUSIONS
  Both magnesium and clonidine attenuated the hemodynamic response to pneumoperitoneum. However, magnesium 50 mg/kg, attenuated hemodynamic response better than clonidine 1 μg/kg.
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Shruthi P
authors.initials: SP
authors.lastname: Kamble
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Yatish
authors.initials: Y
authors.lastname: Bevinaguddaiah
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Dinesh Chillkunda
authors.initials: DC
authors.lastname: Nagaraja
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Vinayak S
authors.initials: VS
authors.lastname: Pujar
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Tejesh C
authors.initials: TC
authors.lastname: Anandaswamy
keywords: Clonidine; laparoscopic cholecystectomy; magnesium; pneumoperitoneum