A comparison study of Dexmedetomidine Vs Clonidine for sympathoadrenal response, perioperative drug requirements and cost analysis

To assess and compare the requirement of preanaesthetic agents to maintain anesthesia within the group of control and groups receiving Clonidine and Dexmedetomidine and reduction in cost due to reduced intraoperative anaesthetic and analgesics requirement. Three groups of control, clonidine and dexmedetomidine were made. Twenty patients of American Society of Anesthesiologist's grade I & II category for ≥ 3 hours of surgery and >18 years of age were involved in the study of six months duration in each group. Hemodynamic variables of all patients were continuously recorded and maintained. Then, during surgery with anesthesiologists we have quantified the amount of drugs spared by use of these alpha2 agonists. Dexmedetomidine and Clonidine were found hemodynamically stable during intubation compared to Control. Dexmedetomidine group showed 25% reduction in Isoflurane and 40% reduction in Diclofenac requirement compared to Clonidine group. The average Fentanyl dose was reduced by 33% and 44 % in Clonidine and Dexmedetomidine group respectively compared to Control group. Diclofenac and propofol requirement was found to be less in dexmedetomidine group than of clonidine. Thus, on average for surgery involving Clonidine INR 1065 per patient were charged while in Dexmedetomidine only INR 833. Significant cost benefit upto INR 463 per patient can be achieved with better hemodynamic control by Dexmedetomidine compared to Control requiring INR 1296. Intraoperatively dexmedetomidine showed significant cardiovascular stability compared to clonidine. Also, Dexmedetomidine group showed significant drug sparing effect of Isoflurane, Thiopentone and Fentanyl than Control group. A clinical pharmacist can assist anesthesiologist's in apt selection of drugs.