Surgical Endoscopy

, Volume 15, Issue 11, pp 1331–1335

Clonidine provides opioid-sparing effect, stable hemodynamics, and renal integrity during laparoscopic cholecystectomy

Authors

  • M. Laisalmi
    • Department of Anaesthesia and Intensive Care Medicine, Surgical Hospital, Helsinki University Central Hospital, P.O. Box 263, 00029 HUS Helsinki, Finland
  • A-M. Koivusalo
    • Department of Anaesthesia and Intensive Care Medicine, Surgical Hospital, Helsinki University Central Hospital, P.O. Box 263, 00029 HUS Helsinki, Finland
  • P. Valta
    • Department of Anaesthesia and Intensive Care Medicine, Surgical Hospital, Helsinki University Central Hospital, P.O. Box 263, 00029 HUS Helsinki, Finland
  • I. Tikkanen
    • Department of Internal Medicine, Helsinki University Central Hospital, Helsinki; Finland and Minerva Foundation Institute, Tukholmankatu 2, 00250 Helsinki, Finland
  • L. Lindgren
    • Department of Anaesthesia and Intensive Care Medicine, Surgical Hospital, Helsinki University Central Hospital, P.O. Box 263, 00029 HUS Helsinki, Finland
Article

DOI: 10.1007/s004640090126

Cite this article as:
Laisalmi, M., Koivusalo, A., Valta, P. et al. Surg Endosc (2001) 15: 1331. doi:10.1007/s004640090126

Abstract

Background: Carbon dioxide pneumoperitoneum causes a hemodynamic stress response and decreases urine output because of an activated renin-angiotensin-aldosterone system (RAAS). Clonidine is a potent antihypertensive drug that suppresses RAAS. Methods: The effects of clonidine 4.5 mg/kg or saline on hemodynamics, neuroendocrine response, and renal parameters were compared in 30 healthy patients undergoing laparoscopic cholecystectomy. Results: Heart rate, arterial blood pressures, and plasma renin activity were lower during and after pneumoperitoneum in patients with clonidine. There were no differences in urine output, urine oxygen tension (reflecting medullary perfusion), or antidiuretic hormone between the groups. N-acetyl-b-D-glucosaminidase, a marker of proximal tubular damage, was minimally elevated after clonidine. Conclusions: Clonidine enabled stable hemodynamics and prevented activation of RAAS seen as unchanged plasma renin activity. Clonidine may be beneficial during laparoscopy in patients with hypertension, cardiovascular, and/or renal diseases.

Copyright information

© Springer-Verlag New York Inc. 2001