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Article Type

Original Study

Abstract

Objectives The aim of this study was primarily to compare the efficacy of oral premedication with pregabalin versus clonidine on stress response and hemodynamic stability during laryngoscopy in adult patients undergoing elective laparoscopic cholecystectomies, and, second, to evaluate sedation, anxiety, and postoperative analgesic effects of both oral premedications. Background Laparoscopic cholecystectomy induces hemodynamic responses, which should be attenuated with appropriate premedication. Moreover, after laparoscopic cholecystectomy, patients report visceral pain and shoulder tip pain resulting from diaphragmatic irritation, which should be relieved with appropriate analgesics. Patients and methods Sixty adult patients aged 18-60 years with American Society of Anesthesiologist physical status I of both sexes scheduled for elective laparoscopic cholecystectomy were randomized to receive pregabalin 300 mg (group P), clonidine 200 μg (group C), or placebo (group O), given 90 min before surgery as oral premedication. Anesthetic technique was standardized and all groups were assessed for preoperative sedation level using the Ramsay Sedation Scale, along with changes in heart rate and mean arterial pressure, before premedication, before induction, after laryngoscopy, after creation of pneumoperitoneum, and after extubation. Intraoperative propofol, isoflurane, and opioid drug requirement and postoperative complications were recorded. Results Perioperative sedation levels were higher with pregabalin than with clonidine, without prolongation of recovery time. Statistically significant attenuation of mean arterial pressure and heart rate to laryngoscopy and laparoscopy was observed in the premedicated groups. The visual analogue scale scores of both the pregabalin and the clonidine group were significantly lower than that in the control group at 1, 4, and 8 h after surgery. Conclusion This study confirms that oral premedication with pregabalin 300 mg or clonidine 200 μg produces sedation and hemodynamic stability during laparoscopic cholecystectomy and a decrease in postoperative pain and analgesic consumption.

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