Original Research Paper

Comparative Observational Prospective Randomized Study To Determine The Effect Of Clonidine As An Adjunct To Induction Agents In Patients Undergoing Coronary Artery Bypass Grafting Surgery

Abstract :

IntroductionAn alpha 2 adrenergic agonist, clonidine has been shown to have perioperative effects such as decreased anaesthetic needs, improved hemodynamic equilibrium, and analgesia, although its therapeutic utility in cardiac surgery remains understudied. AimWe attempted to observe the effect of clonidine as an adjunct to induction agents and study the intraoperative hemodynamics in patients undergoing coronary artery bypass grafting surgery (CABG). MethodsEighty subjects were recruited as per the eligibility criteria and subdivided into two groups with forty subjects each, i.e., the control group receiving normal saline and the case groups receiving I.V. clonidine as a pre-medication dose of 4g/kg in the OT. The patients were then induced with injections of midazolam (0.1 mg/kg), fentanyl (5-10 g/kg) and vecuronium (0.1mg/kg). For maintenance, a sevoflurance (2%) sedation mixture was used. Various intraoperative and hemodynamic parameters were monitored at various timepoints. ResultIn control groups, parameters such as SBP, DBP, HR, MAP, and HCO3 significantly deviated from baseline, albeit the case group displayed the stabilised effect of clonidine over these parameters when compared to their baseline values. On the other hand, parameters like CVP, K+, PCO2, PO2, ACT, and HCT values significantly differed in both the groups upon intragroup comparison from baseline. Conclusion Upon comparison, premedication treatment with intravenous clonidine as an adjunct to induction agents in patients undergoing coronary artery bypass grafting surgery (CABG) reduced hyperdynamic responses to anaesthesia and surgery.

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