An Observational Study To Compare Intravenous Clonidine And Intravenous Dexmedetomidine For Attenuation Of Hemodynamic Response To Laryngoscopy And Intubation

Abstract

Background: The painful stimuli laryngoscopy and tracheal intubation cause a rise in heart rate (HR) and blood pressure (BP), which is a brief but noticeable sympathetic reaction. Life-threatening consequences including abrupt cardiac failure, myocardial ischemia, and cerebrovascular accidents might result from these alterations.

Objective: Objectives of this non-randomized, observational and single-center study was to compare intravenous dexmedetomidine and intravenous clonidine on hemodynamic response to laryngoscopy and intubation and to record side effects if any.

Materials and Methods: This study was conducted among 50 patients of ASA 1 and 2 who were scheduled for ENT surgeries in Dhiraj Hospital, Vadodara, Gujarat. All patients were divided into 2 groups of 25 each depending upon the drug they received.

Group D Patients received Inj. Dexmedetomidine 1mcg/kg over 10 mins in 100ml NS before induction and Group C Patients received Inj. Clonidine 2mcg/kg over 10 mins in 100ml NS before induction. All patients were pre medicated with Inj. Glycopyrrolate 0.004mg/kg IV, Inj. Ondansetron 0.1mg/kg IV, Inj. Midazolam 0.002mg/kg IV and Inj. Tramadol 2mg/kg IV. Anaesthesia was induced with Inj. Propofol 2mg/kg IV followed by Inj. Succinylcholine 2mg/kg IV. All parameters like Pulse Rate, Systolic BP, Diastolic BP and MAP were recorded at regular intervals. Complications (if any) were also observed during perioperative period.

Results: HR was significantly lower in Group D compared to Group C after drug infusion.

HR, SBP, DBP, and MAP were lower in Group D than Group C at all times measured except at 1 min after intubation where SBP and MAP were lower in Group C compared to Group D. At 3, 5, and 10 min after intubation, SBP, DBP, and MAP were lower in Group D compared to Group C.

Conclusion: There was significant reduction in hemodynamic response by dexmedetomidine and clonidine to laryngoscopy and tracheal intubation. The attenuation of pressor response to intubation and laryngoscopy was better following premedication with Dexmedetomidine than with Clonidine