Comparative Study of Oral Clonidine Versus Gabapentin as Premedication for Anxiolysis, Sedation and Attenuation of Pressor Response to Laryngoscopy and Tracheal Intubation

Background and Aims: We conducted a prospective, randomized, double-blind and controlled trial to compare the effects of oral clonidine and gabapentin as premedication in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery. We also compared the preoperative anxiety and sedation status between these two drugs.Materials and Methods: A total of 60 patients of American Society of Anesthesiologists (ASA) physical status I, aged 20 -50 years of either sex enrolled in the study were randomly divided into two groups of 30 each. Group A patients received oral clonidine 200 mcg and Group B patients received oral gabapentin 900 mg, 90 minutes prior to induction of anesthesia. The heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed and recorded pre and post endotracheal intubation. Anxiety and sedation score were noted after 60 minutes of oral administration of drug as well as before induction of anesthesia.Results: Both groups were matched for age, sex, weight and intubation time. Anxiety score and sedation score before induction were significantly better in clonidine group as compared with gabapentin group. Also oral clonidine attenuated the increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure better than oral gabapentin (p<0.05).Conclusion: Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin. Also clonidine is better agent as anxiolytic and sedative than gabapentin.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 131-136

[1]  A. S. Sundar,et al.  The effects of dexmedetomidine on attenuation of stress response to endotracheal intubation in patients undergoing elective off-pump coronary artery bypass grafting. , 2012, Annals of cardiac anaesthesia.

[2]  H. Islami,et al.  Adrenergic Agonist and Antagonist Action in Airways of Patients withBronchial Asthma , 2011 .

[3]  J. Henderson.  Airway Management in the Adult , 2010 .

[4]  H. Türe,et al.  Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast-track CABG. , 2010, Annals of cardiac anaesthesia.

[5]  A. Saliminia,et al.  Attenuation of hemodynamic responses following laryngoscopy and tracheal intubation -- comparative assessment of clonidine and gabapentin premedication. , 2009, Middle East journal of anaesthesiology.

[6]  M. Türe,et al.  Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation , 2006, European journal of anaesthesiology.

[7]  A. Paraskeva,et al.  Gabapentin attenuates the pressor response to direct laryngoscopy and tracheal intubation. , 2006, British journal of anaesthesia.

[8]  P. Kam,et al.  Gabapentin: pharmacology and its use in pain management , 2002, Anaesthesia.

[9]  D. Mcatamney,et al.  Bolus dose remifentanil for control of haemodynamic response to tracheal intubation during rapid sequence induction of anaesthesia. , 1999, British journal of anaesthesia.

[10]  D. Rose,et al.  The airway: problems and predictions in 18,500 patients , 1994, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[11]  R. Martineau,et al.  Effects of Alfentanil on the Hemodynamic and Catecholamine Response to Tracheal Intubation , 1993, Anesthesia and analgesia.

[12]  G. Puri,et al.  Effect of nifedipine on cardiovascular responses to laryngoscopy and intubation. , 1988, British journal of anaesthesia.

[13]  R. Matteo,et al.  Evaluation of esmolol in controlling increases in heart rate and blood pressure during endotracheal intubation in patients undergoing carotid endarterectomy. , 1986, Anesthesiology.

[14]  P. Duke,et al.  Effects of Clonidine on Narcotic Requirements and Hemodynamic Response during Induction of Fentanyl Anesthesia and Endotracheal Intubation , 1986, Anesthesiology.

[15]  M. Davies,et al.  The prevention of hypertension at intubation , 1981, Anaesthesia.

[16]  R. Stoelting.  Attenuation of Blood Pressure Response to Laryngoscopy and Tracheal Intutation with Sodium Nitroprusside , 1979, Anesthesia and analgesia.

[17]  R. Stoelting.  Circulatory changes during direct laryngoscopy and tracheal intubation: influence of duration of laryngoscopy with or without prior lidocaine. , 1977, Anesthesiology.

[18]  J. D. Elder,et al.  REFLEX CIRCULATORY RESPONSES TO DIRECT LARYNGOSCOPY AND TRACHEAL INTUBATION PERFORMED DURING GENERAL ANESTHESIA , 1951, Anesthesiology.