DOI: 10.36347/sjams.2020.v08i08.034

Pages: 1959-1964

Background: In stressful conditions, raising haemodynamic parameters and blood glucose concentration are closely related to an increase in catecholamines and cortisol release. Clonidine, a centrally acting α2-adrenoceptor agonist has neuroendrocrine effects including inhibition of sympathoadrenal activity and ACTH & cortisol release. Therefore, clonidine premedication during surgery has been proposed as a way of improving perioperative haemodynamic status and blood glucose control in diabetic patients. Objectives: The present study was designed to observe the effects of oral clonidine premedication on blood glucose control and haemodynamic status in type-II diabetic patients undergoing major gynaecological surgery under general anaesthesia. Methods: A total number of sixty female type-II diabetic patients were selected randomly into two groups, thirty in each group. Group-A (control) received no premedication and Group-B (experimental) received oral clonidine (100µg) 90 minutes before surgery. Patients were given insulin by continuous IV infusion to maintain blood glucose in the range of 5.5-11.1 mmol litre-1. Haemodynamic parameters were measured every 10 min interval and blood glucose concentrations were measured every 30 min during surgery & hourly for 4 h after surgery. Total requirement of insulin for both groups were calculated during the period. Results: Haemodynamic parameters of the clonidine group were significantly stable (p<0.01) in comparison to control group. Glycaemia was significantly lower in the clonidine group (p<0.001) and the total amount of insulin administered was significantly reduced: clonidine group 9.3±0.5 units; control group 17.8±0.6 units (p=0.000). Conclusion: Clonidine premedication in type-II diabetic patients 90 min before surgery ensures haemodynamic stability, blood glucose control and decreases insulin requirement during major gynaecological surgery under general anaesthesia.