Comparison of oral premedication with clonidine versus pregabalin for hemodynamic stability during laparoscopic cholecystectomy under general anaesthesia : A double blinded randomized control study.

     Laparoscopic surgeries are now a days being the standard approach for most common surgical procedures. It has gained popularity in clinical practice in view of shorter hospital stay, early ambulation, smaller incisional scar, and less compromised postoperative respiratory and gastrointestinal function. However it is associated with significant intraoperative haemodynamic changes largely due to creation of carbon-di-oxide pneumoperitoneum to facilitate the surgery. Mechanical effects of pneumoperitoneum, systemic absorption of carbon-di-oxide (CO2) causing release of catecholamines and patient positioning also contribute to various unfavourable haemodynamic responses. These surgeries are done under general  anaesthesia with direct laryngoscopy for tracheal intubation which is associated with autonomic changes like tachycardia, hypertension and dysrhythmias  which are usually well  tolerated in ASA grade I & II patients and maybe detrimental in patients with pre-existing diseases.

Clonidine is an α-2 adrenoreceptor agonist with central sympatholytic effect. Premedication with clonidine blunts the haemodynamic stress responses to direct laryngoscopy and tracheal intubation and it also stabilizes blood pressure by increasing cardiac baroreceptor reflex sensitivity. Pregabalin, a gabapentinoid compound appears to produce an inhibitory modulation of neuronal excitability particularly in neocortex, amygdala and hippocampus of CNS. It possess analgesic, anticonvulsant and anxiolytic activity by reduction of neurotransmitter glutamate, nor-adrenaline, serotonin, dopamine and substance P.

The aim of the study is to compare the efficacy of oral clonidine with oral Pregabalin in maintaining hemodynamic stability during laparoscopic cholecystectomy under general anaesthesia.