Title: Efficacy of Oral Atenolol and Oral Vitamin C Premedication on Hemodynamic Response in Patients Undergoing Elective Laparoscopic Cholecystectomy

Authors: Dr Anil Sathyadas, Dr Geetha Kumari

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i6.154

Abstract

Back Ground & Objectives: Physiologic effects of prolonged carbon dioxide insufflation have a major impact on cardiopulmonary function. Atenolol, has been extensively studied but only few attempts have been made to evaluate it in laparoscopic surgeries. Study was aimed to evaluate the clinical effects of oral Atenolol premedication in attenuating the hemodynamic changes during the period of pneumoperitoneum in patients undergoing laparoscopic cholecystectomy.

Methods: Prospective, randomized, double blinded study was conducted, on fifty ASA I & II patients, 30 to 60 years, for elective laparoscopic cholecystectomy. Group I (Atenolol): Atenolol tablet. Group II (Placebo): Vitamin C tablet. Premedication, preoxygenation, induction intubation and maintenance was standardised for both groups. Monitoring data was recorded every 2 minutes for the first 30 minutes of pneumoperitoneum and thereafter every 5 minutes for the rest of the operation.

Results: Comparisons of values bring out the difference in the hemodynamics between the two groups, with a statically significant lower level in Atenolol group.

Conclusions: Atenolol 50mg premedication elective laparoscopic cholecystectomy can bring in a stable hemodynamics compared to placebo.

Keywords: Atenolol, Cholecystectomy, Hemodynamics, Laparoscopy, Premedication.

References

1.      Alexander J. I., Pain after laparoscopy, British Journal of Anaesthesia, Vol. 79, pp-369, 1997.

2.      Mangano DT, Browner WS, Hollenberg M, et al: Long‑term cardiac prognosis following non cardiac surgery. The Study of Perioperative Ischemia Research Group, JAMA , 268:233, 1992.

3.      Joris J.L, Anaesthesia for laparoscopic surgery. In Miller's Anaesthesia, 6th ed. Philadelphia, Elsevier, 2005, p2285.

4.      Joris J.L., Noirot DP, Legrand MJ, et al: Haemodynamics changes during laparoscopic cholecystectomy. Anesthesia Analgesia, 76:1067, 1993.

5.      Johannson G, Andersen M, Juhl B: The effect of general anaesthesia on the haemodynamic events during laparoscopy with C02 ‑insufflation., Acta Anaesthesiol Scandanavia , 33:132, 1989.

6.      Joris J.L, Chiche JD, Canivet JL, et al: Hemodynamic changes induced by laparoscopy and their endocrine correlates: Effects of clonidine, Journal of American College of Cardiology, 32:1389,1998

7.      Morris J.J,, Perkins S.R., Hein HAT, et al., Physiologic alterations during laparoscopic cholecystectomy in cardiac transplant patient, Anesthesia Analgesia, 80:S329, 1995.

8.      Stanley Tam, Chung, Campbell, Intravenous lidocaine: Optimal time of injection before tracheal intubation. Anaesthesia Analgesia, 1987; 66:1036-1038

Corresponding Author

Dr Anil Sathyadas

Associate Professor, Department of Anaesthesiology,

Medical College Thiruvananthapuram, Kerala