Comparison of two doses of oral clonidine as a premedicant for attenuation of pressor response to laryngoscopy.

ABSTRACT

Background: The present study compared oral clonidine 0.3mg with 0.2 mg to attenuate hemodynamic response to laryngoscopy and intubation and also to evaluate the optimal dose of oral clonidine as premedication. Methods: A prospective, randomized, double blind trial performed on 40 patients of ASA Grade I & II, scheduled for planned ENT surgeries under general anaesthesia. Patients were divided into 2 groups depending on oral clonidine dose given 90 mins prior to induction. Group A received 0.3 mg while group B received 0.2 mg clonidine. Heart rate, SBP, DBP, MAP were monitored at various time intervals e.g. before premedication, before induction, at laryngoscopy, intubation, immediately after intubation and post intubation for 30 minutes. Patients were anesthetized with sodium thiopentone (2.5%) 5-7 mg/kg followed by suxamethonium 2 mg/kg i.v. Results: We observed a significant decrease in mean HR,SBP,DBP,MAP in both the groups (clonidine 0.2 and 0.3mg ) as compared to baseline and preinduction level. Tablet Clonidine 0.3 mg proved to be significantly effective in checking the rise in SBP. A highly significant (p < 0.01) fall in DBP was observed in Group A at 1, 3, 15, 30 mins post intubation as compared to Group B. At 3 min, 15 min and 30 min interval, highly significant (p <0.01) decrease in MAP observed with clonidine 0.3mg as compared to 0.2mg. In this study, no patient encounter complications like bradycardia, hypotension. Conclusions: Oral clonidine 0.3 mg premedication in adult patients 90 mins prior to induction is safe, convenient and more effective in suppressing the hemodynamic response to laryngoscopy & intubation as compared to clonidine 0.2 mg.