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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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ISSN 1681-715X |
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ORIGINAL ARTICLE |
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Volume 25 |
October - December 2009 (Part-I) |
Number 5 |
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Clonidine reduces post operative nausea and
vomiting in laparoscopic gynecological surgery
Javaherfroosh F1, M. Raza Pipelzadeh2, Namazi M3
ABSTRACT
Objective: Post operative nausea and vomiting (PONV) is a distressing phenomenon after obstetrics laparoscopic surgery. In this study we assessed the efficacy of oral clonidine in controlling PONV in patients undergoing this type of surgery.
Methodology: In this prospective double blind study, 86 patients in ASA class one or two were selected. The study group (n=43) received clonidine 0.2mg tablet with 50ml water 60–90 minutes before surgery while control group (n=43) received placebo (the tablets were made at Ahwaz Pharmaceutics Department). All patients were monitored for 24 hour post-operatively for presence of PONV. Hemodynamic changes after intubation between these groups were compared. Sedation and pain scores were also recorded during recovery using Ramsay score and by visual analogue scale respectively.
Results: Mean age in clonidine group was 28.5 years, and in control group was 30 years. Nine (21%) patients in study group and 19(44%) patients in control group nauseated. Seven (16.3%) patients in study group and 15 (34.9%) patients in control group vomited (P<0.05). Moderate pain was reported in 18 (41.9%) patient in study group as compared to15 (34.9%) in control group. Severe pain was reported in seven (16.3%) patients in study group as compared to 21(48.8%) in control group (P<0.01). Four (9.3%) patient in clonidine group and 12 (27.9%) in control group received rescue anti-emetics (P<0.05). Mean blood pressure after intubation did not change in 35 (81.4%) of clonidine group compared to 26 (60.5%) in control group. Mean blood pressure on intubation decreased in five (11.5%) in clonidine group as compared to three (7%) in control group (p<0.02). Heart rate was reduced in five (11.5%) study group, while only two (4.7%) in control group (p=0.001). Ramsay sedation score was higher in most patients in clonidine group. Twelve (27.9%) patients in clonidine group had Ramsay score >3 compared to only 4 (9.3%) patients in control group (P<0.01).
Conclusions: Clonidine had statistically significant effect in reducing incidence of both nausea and vomiting. In addition it has favorable outcome on post operative pain score. Despite some limitations regarding higher sedation scores, no cases of significant hypoxemia or drop in blood pressure and heart rate was seen in both groups. It is an oral effective, inexpensive, readily available drug with low side effects and thus we suggest its routine use in laparoscopic surgery.
KEY WORD: Nausea, Vomiting, Laparoscopy, General anesthesia.
Pak J Med Sci October - December 2009 (Part-I) Vol. 25 No. 5 782-785
How to cite this article:
Javaherfroosh F, Pipelzadeh MR, Namazi M. Clonidine reduces post operative nausea and vomiting in laparoscopic gynecological surgery. Pak J Med Sci 2009;25(5):782-785.
1. Javaherfroosh F, MD
Assistant Professor, Anesthesia Department,
Imam Khomeini Hospital,
Azadegan St., Ahvaz – Iran.
2. Pipelzadeh MR, MD
Associate Professor, Anesthesia Department,
3. Namazi M, MD
Resident, Anesthesia Department,
1-3: Ahvaz Jundishapur University of Medical Sciences,
Ahvaz – Iran.Correspondence
Dr. Mohammad Reza Pipelzadeh,
E-mail: dr_rpipel@yahoo.com
* Received for Publication: March 9, 2009
* Revision Received: March 12, 2009
* Accepted for Publication: August 30, 2009
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