What is the clinical evidence from this study?

Study design: RCT. Population: elective laparoscopic cholecystectomy (n=40). Intervention: Clonidine vs. Placebo. Primary outcome: Hemodynamics and plasma levels of cortisol, catecholamines and vasopressin.

What question did this study set out to answer?

Investigate the endocrine drivers of hemodynamic shifts caused by carbon dioxide pneumoperitoneum and determine whether preoperative clonidine attenuates these changes by reducing hormone release.

September 14, 2026Journal of the American College of CardiologyOpen Access

Hemodynamic changes induced by laparoscopy and their endocrine correlates: effects of clonidine

Q: What are the key findings of this study?

Carbon dioxide pneumoperitoneum increased systemic vascular resistance (70+/-12%) and vasopressin (129+/-42 pg/ml; p<0.05), while clonidine pretreatment significantly attenuated hemodynamic changes.

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Key result

Clonidine pretreatment blunts hemodynamic shifts and prevents the ~70% surge in SVR during pneumoperitoneum.

n=40

Why the study?

No study had correlated hemodynamic changes induced by carbon dioxide pneumoperitoneum with changes in levels of potential endocrine mediators or assessed clonidine's effect on these changes.

Does clonidine attenuate hemodynamic changes and endocrine release induced by carbon dioxide pneumoperitoneum in healthy patients undergoing laparoscopic cholecystectomy?

Comparison

Clonidine 8 microg/kg infusion vs placebo before pneumoperitoneum

Design

Randomized controlled trial with two studies including observational and randomized components

Follow-up

During pneumoperitoneum and after exsufflation

Authors

JJJean JorisReal Academia Española JCJean‐Daniel ChicheUniversité Paris-Sud JCJean-Luc CanivetCentre Hospitalier Universitaire de Liège

Discussion

Member takes

Implication

Clonidine administered before pneumoperitoneum attenuates hemodynamic changes and reduces catecholamine release during laparoscopy.

Key Points

Investigate the endocrine drivers of hemodynamic shifts caused by carbon dioxide pneumoperitoneum and determine whether preoperative clonidine attenuates these changes by reducing hormone release.
Conducted two clinical studies in healthy patients scheduled for elective laparoscopic cholecystectomy (N=20 per study).
Study 1 monitored thermodilution hemodynamics and serial plasma levels of cortisol, catecholamines, vasopressin, renin, endothelin, and prostaglandins during laparoscopy and after exsufflation.
Study 2 randomized patients to receive either an intravenous infusion of clonidine (8 µg/kg over 1 hour) or placebo before pneumoperitoneum.
Pneumoperitoneum decreased cardiac output by 18±4% while increasing mean arterial pressure by 39±8%, systemic vascular resistance by 70±12%, and pulmonary vascular resistance by 98±18%.
Vasopressin concentrations surged immediately following insufflation from 6±4 pg/ml to 129±42 pg/ml (p < 0.05), closely paralleling systemic vascular resistance, alongside significant rises in cortisol, catecholamines, and renin.
Pretreatment with clonidine significantly reduced mean arterial pressure, heart rate, systemic vascular resistance elevation, and catecholamines, but did not alter vasopressin or cortisol levels.

Study Design

Type

RCT (n=40)

Randomization

randomly allocated

Structured PICO

Does clonidine attenuate hemodynamic changes and endocrine release induced by carbon dioxide pneumoperitoneum in healthy patients undergoing laparoscopic cholecystectomy?

Population

40 healthy patients scheduled for elective laparoscopic cholecystectomy evaluated across two studies for hemodynamic and endocrine changes during pneumoperitoneum.

Intervention

Clonidine 8 microg/kg infused over 1 h before carbon dioxide pneumoperitoneum

Comparator

Placebo

Outcome

Hemodynamic changes (mean arterial pressure, heart rate, systemic vascular resistance) and plasma levels of cortisol, catecholamines, and vasopressin during pneumoperitoneum and after exsufflationsurrogate

Clonidine administered before pneumoperitoneum attenuates hemodynamic changes and reduces catecholamine release during laparoscopy.

Cite This Study

Joris et al. (1998) conducted an RCT in elective laparoscopic cholecystectomy (n=40). Clonidine vs. Placebo was evaluated on Hemodynamics and plasma levels of cortisol, catecholamines and vasopressin. Carbon dioxide pneumoperitoneum increased systemic vascular resistance (70+/-12%) and vasopressin (129+/-42 pg/ml; p<0.05), while clonidine pretreatment significantly attenuated hemodynamic changes.

synapsesocial.com/papers/6aa86413f5b0d9afe7fa24bc https://doi.org/10.1016/s0735-1097(98)00406-9

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Hemodynamic changes induced by laparoscopy and their endocrine correlates: effects of clonidine

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Hemodynamic changes induced by laparoscopy and their endocrine correlates: effects of clonidine

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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