An Observational Study of Intravenous Dexmedetomidine and Clonidine for Attenuating Haemodynamic Response to Laryngoscopy and Intubation in Patients Undergoing General Anaesthesia
Keywords:Dexmedetomidine, Clonidine, haemodynamic response, laryngoscopy, intubation, general anaesthesia
Background: Laryngoscopy and endotracheal intubation alters cardiovascular physiology causing
hypertension and tachycardia. Dexmedetomidine, an alpha 2 adrenergic receptor produces analgesia
by direct activation of descending inhibitory pain pathway and inhibiting the release of substance P.
Clonidine a centrally acting alpha 2 adrenergic agonist decreases central sympathetic nervous system in all
hyperadrenergic situations. Hence we compare haemodynamic effects between dexmedetomidine 0.5 mcg/
kg and clonidine 1mcg/kg during after laryngoscopy and tracheal intubation for patients undergoing general
Method: Patients were allocated randomly into 2 groups of 30 each. Group D received dexmedetomidine
0.5mcg/kg diluted in 10ml NS and group C- clonidine 1 mcg/kg diluted in 10ml NS intravenously and
hemodynamic parameters were observed. Dexmedetomidine/ Clonidine according to groups is given
intravenously with premedication. After 5 minutes patients were induced with 2.5% thiopentone 5-7 mg/kg
and succinyl choline 2mg/kg and intubated with appropriate sized cuffed ETT. Anaesthesia was maintained
with O2, N2O, isoflurane and vecuronium bromide 0.08mg/kg.
Results: Haemodynamic changes after laryngoscopy and intubation were recorded at baseline, premedication,
induction, intubation, 1, 3, 5,10 and 15 minutes. The initial fall in HR is more in Group C compared to Group
D but the difference was insignificant, but since intubation till 10min post intubation HR was significantly
(p<0.05) supressed more in Group D. Similarly fall in SBP and DBP is significantly (p<0.05) more in Group
D compared to Group C.
Conclusion: Dexmedetomedine 0.5 mcg/kg intravenously 15 minutes prior to laryngoscopy and intubation
attenuates the sympathetic response better as compared to clonidine without major side effects.
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