Pre-medication with I.V. dexmedetomidine Vs I.V. clonidine in attenuating the pressor response during laryngoscopy & endotracheal intubation

Abstract

Aim of study: This randomized prospective study is done to compare the effects of single premedication dose of I.V dexmedetomidine with IV clonidine in attenuating pressor response to laryngoscopy and endotracheal intubation. Method: Patients were randomly divided into 2 groups of 30 each. Group I patients received clonidine 3 g/kg and Group II patients received Dexmedetomidine 1microgm/kg in 100ml NS 10 min before induction. HR (Heart Rate), SBP (Systolic blood pressure), DBP (Diastolic BP), MAP (Mean Arterial Pressure) were monitored at T_0,T_1,T₂,T_3,T_4,T_5,T₆ respectively. Patients were maintained with O₂, N₂O, Isoflurane and vecuronium at titrated doses. Results: In both the groups patients had attenuation of sympathetic response with decrease in HR and BP. At 1min and 3 min after Intubation rise in HR was more in clonidine group which is statistically significant (p 0.01). Fall in BP was comparable with both groups, after administering the study drug and at induction. At 1, 3, 5, 10 min after intubation both groups showed suppression of SBP, DBP, MAP (p>0.05) There was increase in HR in both the groups at 1, 3, 5, 10 min after intubation but increase in HR was more in clonidine group which is statistically significant (p 0.01). Conclusion: From this study we conclude that both clonidine and dexmedetomidine attenuates the pressor response during laryngoscopy and Intubation but Dexmedetomidine is better in attenuating the tachycardia response. T₀- Basal reading when the patient is shifted to OR, T₁- At 5 min after infusion of dexmedetomidine /clonidine, T₂- At Induction, T₃ to T₆ -At 1,3,5 and 10 min after intubation.