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Effect of Clonidine on Hemodynamic Responses During Laparoscopic Cholecystectomy: A Systematic Review and
1Department of Hepatobiliary Surgery, Chongqing Cancer Institute & Hospital & Cancer Center, Chongqing, China.
Insights
Clonidine significantly reduces hemodynamic responses, including mean arterial pressure and heart rate, during laparoscopic cholecystectomy. This intervention also decreases propofol needs and postoperative nausea and vomiting.
Area of Science:
- Anesthesiology and Perioperative Medicine
- Surgical Patient Management
Background:
- Clonidine may offer benefits for patients undergoing laparoscopic cholecystectomy.
- Hemodynamic stability is crucial during this surgical procedure.
Purpose of the Study:
- To evaluate the influence of clonidine on hemodynamic responses in patients during laparoscopic cholecystectomy.
- To assess the impact of clonidine on other perioperative outcomes.
Main Methods:
- A systematic meta-analysis of randomized controlled trials was conducted.
- Searches were performed across major databases (PubMed, EMbase, Web of Science, EBSCO, Cochrane Library).
- Primary outcomes included mean arterial pressure (MAP) and heart rate (HR) at pneumoperitoneum; a random-effect model was used.
Main Results:
- Clonidine significantly reduced MAP and HR during pneumoperitoneum and intubation compared to placebo.
- A notable decrease in propofol requirement was observed with clonidine use.
- Postoperative nausea and vomiting incidence was significantly lower in the clonidine group.
Conclusions:
- Clonidine effectively mitigates adverse hemodynamic responses during laparoscopic cholecystectomy.
- The use of clonidine is associated with reduced anesthetic agent requirements and improved postoperative outcomes.
- Clonidine represents a potentially valuable adjunct for enhancing patient recovery after laparoscopic cholecystectomy.
Background:
Clonidine might be beneficial to the patients undergoing laparoscopic cholecystectomy. This meta-analysis focused on the influence of clonidine on hemodynamic responses in patients undergoing laparoscopic cholecystectomy.
Methods:
We searched several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases. This meta-analysis included randomized controlled trials regarding the influence of clonidine versus placebo on laparoscopic cholecystectomy. The primary outcomes were mean arterial pressure (MAP) and heart rate (HR) at pneumoperitoneum. The random-effect model was applied for this study.
Results:
Compared with control intervention, clonidine intervention was found to significantly reduce the MAP at pneumoperitoneum [standard mean difference=-2.58; 95% confidence interval (CI),-4.63 to -0.53; P=0.01), HR at pneumoperitoneum (standard mean difference=-3.67; 95% CI, -6.57 to -0.76; P=0.01), MAP at intubation (standard mean difference=-2.40; 95% CI, -4.75 to -0.06; P=0.04), HR at intubation (standard mean difference=-3.39; 95% CI, -5.75 to -1.02; P=0.005), propofol requirement (standard mean difference=-2.25; 95% CI, -4.01 to -0.48; P=0.01), as well as postoperative nausea and vomiting (risk ratio, 0.35; 95% CI, 0.19-0.63; P=0.0005).
Conclusions:
Compared with control intervention, clonidine intervention was found to significantly reduce MAP and HR at pneumoperitoneum and intubation, propofol requirement, as well as postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
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