A prospective randomized double blind study to compare the efficacy of oral Clonidine to intravenous Lignocaine for attenuation of haemodynamic response to laryngoscopy and tracheal intubation

Authors

  • Sweetline Subha M Department of Anaesthesia, SMCSI Medical College, Karakonam
  • Sasidharan Nair M Department of Anaesthesia, SMCSI Medical College, Karakonam
  • M. Paul Wilson Department of Anaesthesia, SMCSI Medical College, Karakonam
  • Ashabi M Department of Anaesthesia, SMCSI Medical College, Karakonam
  • Salini R Varma Department of Anaesthesia, SMCSI Medical College, Karakonam

DOI:

https://doi.org/10.7439/ijbr.v7i7.3437

Keywords:

Homicide, Strangulation, Post-mortem burns.

Abstract

A randomized double blinded controlled study was done with oral Clonidine and intravenous Lignocaine. The aim of the study was to compare the laryngoscopy and intubation responses after the administration of the study drug and the control drug. In this study conducted in Regional Cancer centre, Trivandrum we selected 38 patients each in Group A who received oral Clonidine and Group B who received intravenous Lignocaine. The haemodynamic responses in both groups were compared. We concluded that oral Clonidine has better control over haemodynamic responses to laryngoscopy and intubation when compared to intravenous Lignocaine.

Downloads

Download data is not yet available.

Author Biographies

  • Sweetline Subha M, Department of Anaesthesia, SMCSI Medical College, Karakonam

    Assistant Professor

    Department of Anaesthesia

  • Sasidharan Nair M, Department of Anaesthesia, SMCSI Medical College, Karakonam

    Assistant Professor

    Department of Anaesthesia

  • M. Paul Wilson, Department of Anaesthesia, SMCSI Medical College, Karakonam

    Professor

    Department of Anaesthesia

  • Ashabi M, Department of Anaesthesia, SMCSI Medical College, Karakonam

    Junior Resident

    Department of Anaesthesia

  • Salini R Varma, Department of Anaesthesia, SMCSI Medical College, Karakonam

    Junior Resident

    Department of Anaesthesia

References

King BD, Harris LC,Dripps RD. Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during anaesthesia. Anaesthesiology 1951; 12:556-566.

Abou Madi MN, Keszler H, Yacoub JM. A method of prevention of cardiovascular reaction to larygoscopy and intubation. Can Anaesth Soc J. 1975; 22:316.

De Kock M, Famenne F, Deckers G et al, Epidural clonidine or sufentanil for intraoperative and postoperative analgesia. Anesth Analg. 1995; 81:1154-1162.

Howie MB, Hiestand DC, Jopling MW, Effects of oral clonidine, premedication on anesthetic requirement, hormonal response, hemodynamics and recovery in coronary artery bypass graft surgery patients. J Clin Anesth 1996 Jun; 8(4):263-72.

Engelman E, Lipszyc M, Gilbart E, et al. Effects of clonidine on anesthetic drug requirements and hemodynamic response during aortic surgery. Anesthesiology 1989; 71: 178-187.

Flacke JW, Bloor BC, Flacke WE, et al. Reduced narcotic requirement by clonidine with improved hemodynamic and adrenergic stability in patients undergoing coronary bypass surgery. Anesthesiology 1987; 67: 11- 19.

Stoelting Robert K. Pharmacology and physiology in anesthetic practice.3rd ed. Philadelphia, New York. Lippincott-Raven.1999.p158-178,304-307.

Carabine U.A., Wright P.M.C and Moore J. Preanaesthetic medication with clonidine: A dose response study. Br J Anesth 1991; 67:79-83.

Lowenthal, D.T., Matzek, K.M., and Mac Gregor, T.R, Clinical pharmacokinetics of clonidine. Clin pharmacokinet, 1988; 14: 287- 310.

Miller Ronald D, Miller

Tomori Z, Widdicombe JG. Muscular bronchomotor and cardiovascular reflexes elicited by mechanical stimulation of respiratory tract. JI Physiology; 1969:200:25.

Shribman AJ, Smith G. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth.1987; Mar 59(3):295-299.

Wycoff CC. Endotracheal intubation: Effect of blood pressure and pulse rate. Anaesthesiology.1960; 21:153.

Takeshema, Node K. Cardiovascular response to rapd anaesthsia induction and endotracheal intubation. Anaesth Analg Current Research 1964; 43:201.

Dingle HR. Antihypertensive drugs. Anaesthsia 1966; 21:151.

Forbes AM,Dally FG. Acute hypertension during induction of anaesthesia and endotracheal intubation in normotensive man. Br J

Anaesth. 1970; 42:618.

Fox EJ, Sklar GS. Complication related to pressor response to endotracheal intubation. Anaesthesiology.1977; 44:524-526.

Stoelting RK. Circulatory changes during direct laryngoscopy and tracheal intubation: Influence of duration of laryngoscopy with or without prior lidocaine. Anaesthesiology. 1977; Oct 47 (4):381-384.

Stoelting RK. Blood pressure and heart rate changes during short term laryngoscopy for tracheal intubation: Influence of viscous or intravenous lidocaine. Anaesth Analg 1978; mar57 (2):197-199.

Robert G. Burney, Richard Winn. Increased cerebrospinal fluid pressure during laryngoscopy and intubation for induction of anesthesia. Anesth Analg 1975; 54:687-690.

Russel WJ, Morris RG. Changes in plasma catecholamine concentrations during endotracheal intubation. Br J Anaesth.1981; 53:837-839.

Prys-Roberts C, Greene LT, Foex P. Studies of anaesthesia in relation to hypertension II: Haemodynamic consequences of induction and endotracheal intubation. Br J Anaesth 1971; 43:531.

Abou Madi MN, Keszler H, Yacoub JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous dose of lidocaine. Can Anaesth Soc J. 1977; Jan 24 (1):12-19.

Hamill JF,Bedforde RF,Weaver DC. Lidocaine before endotracheal intubation intravenously or laryngotracheal. Anaesthesiology 1981; 55:578-579.

Asfar SN, Abdulla WY. The effect of various administration routes of lidocaine on haemodynamics and ECG rhythm during endotracheal intubation. Acta Anaesth Belg. 1990; 41(1):17-24.

Derbyshire DR, Smith G. Effect of topical lignocaine on sympathoadrenal responses to tracheal intubation. Br J Anaesth. 1987; Mar 59 (3):300-304.

Kautto UM, Heinonen J. Attenuation of circulatory responses to laryngoscopy and tracheal intubation. A comparison of two methods of topical anaesthesia. Acta Anaesthesiol Scand.1982; Dec 26 (6):599-602.

Stoelting RK. Circulatory response to laryngoscopy and tracheal intubation with or without prior oropharyngeal viscus lidocaine. Anaesth Analg 1977 Sep; 56(5):618-621.

Sklar BZ, Lurie S.Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation. J Clin Anaesthesia.1989; July36 (4):370-376.

Mostafa SM, Barrett PJ, Mcttugh P. Comparison of the effects of topical lignocaine spray applied before or after induction of anaesthesia in the pressor responses to direct laryngoscopy and intubation. Eur J Anaesthesiology.1999 Jan; 16(1):7-10.

Scott DB, Littlewood DG. Plasma lignocaine concentration following endotracheal spraying with an aerosol. Br J Anaesth. 1976; 48:899.

Youngberg JA, Graybar G, Hutchings D. Comparision of intravenous and topical lignocaine in attenuating cardiovascular responses to endotracheal intubation. South Med J. 1983; Sep76 (9):1122-1124.

James F, Hamlil MD,Robert F. Lignocaine before endotracheal intubation: intravenous or laryngotracheal spray. Anaesthesiology 1981; 55:578.

Tam S, Campbell M. Attenuation of circulatory responses to endotracheal intubation using intravenous lidocaine: A determination of optimal time of injection. Anaesth Analg 1987; 66:1036-38.

Yukoika H, Nishimura K, Fujimori M. Intravenous lidocaine as a suppressant of coughing during tracheal intubation. Anaesth Analg. 1985; Dec 64(12):1189-1192.

Poulton TJ, James FM. Cough suppression by lignocaine. Anaesthesia 1979; 50:470-472.

Splinter FM, Crevenkof. Haemodynamic responses to laryngoscopy and tracheal intubation in geriatric patients: Effects of fentanyl, lidocaine and thiopentone. Can J Anaesth 1989 July; 36(4):370-376.

Vnus B, Polassani V, Pharm G. Effects of aerosolized lidocaine on circulatory responses to laryngoscopy and tracheal intubation. Crit Care Med.1984; Apr 12(4):391-394.

Steinhause JE, Gaskin L. A study of lidocaine as suppressant of cough reflex. Anaesthsiology.1963; 24:285-290.

Bidawi AVC, Bidwani VA. Blood pressure and pulse rate response to extubation with or without prior topical tracheal anaesthesia.1979; 25:416.

Baraka A. Intravenous lignocaine controls extubation laryngospasm in children. Anaesth Analg 1978; 57:506.

Bulowk, Lund J. the effect of topical on intubating conditions after propofol -alfentanil induction. Acta Anaesthesiol Scand. 1996; 40:752-756.

Denlinger JK, Ellison N. Effects of intratracheal lidocaine on circulatory responses to tracheal intubation. Anaesthesiology. 1974 Oct; 41:409-412.

McCoy E.P EP, Mirakhur RK, Mccloskey. A comparison of stress response to laryngoscopy, The Macintosh Vs The Mc Coy Blade Br J Anaesth 1995; 50: 943-946.

Kaul Tej, Veena Valecha et al. Catecholamine responses to Endotracheal intubation and Laryngeal Mask Airway Insertion. Indian J Anaesth; 1999: (43):30.

Takita K, Morimoto Y, Kemmotsu O. Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation. Can J Anaesth 2001 Sep; 48(8):7326.

Costello TG, Cormack JR. Clonidine premedication decreases hemodynamic responses to pin head-holder application during craniotomy. Anesth Analg. 1998; 86:1001-1004.

Laurito C.E., Baughman V.L. Becker G.L et al. Oral clonidine blunts the haemodynamic responses to brief but not prolonged laryngoscopy. J Clin Anaesth. 1993; Jan

Britto JA, McCoy D, Fourie LR. Clonidine as premedication for rhinoplasty. Plast Reconstr Surg. 1997; 100:548-549.

Herman VS, Joffe BI, Kalk WJ, et al. Clinical and biochemical responses to nadolol and clonidine in hyperthyroidism. J Clin Pharmacol 1989; 29:1117-1120.

Mikawa K, Nishina K, Maekawa N et al. Attention of the catecholamine response to tracheal intubation with oral clonidine in children. Can J Anesth, 1995; 42: 869-874.

Zalunardo MP, Zollinger A, Spahn DR et al. Effects of intravenous and oral clonidine on hemodynamic and plasma-catecholamine response due to endotracheal intubation. PMID: 9075040.

Kulka PJ, Tryba M, Zenz M. Dose response effects of intravenous clonidine on stress response during introduction of anesthesia in coronary artery bypass graft patients. Anest. Analg 1995; 80: 263-268.

Yokota S, Komatsu T, Yano K et al: Effect of oral clonidine premedication on hemodynamic responses during sedated nasal fibreoptic intubation. Nagoya J. Med Sci; May 1998:61:47-52.

Gupta P. K., Sehgal R., Gupta M et al. Attenuation of cardiovascular responses to ketamine: comparative evaluation of clonidine. Indian J Anaesth. 2002; 46 (6) : 457-459.

Nishina, Kahoru MD, Mikawa et al. Oral Clonidine Premedication Blunts the Heart Rate Response to Intravenous Atropine in awake Children. Anesthesiology.1995; 82(5):1126-1130.

Raval Dipak L., Mehta Malini K. Oral clonidine premedication for attenuation of haemodynamic response to laryngoscopy and intubation. Indian J Anaesth. 2002; 46 (2): 124-129.

Das AK, Rudra R. Clinical efficacy of oral clonidine as a preanaesthetic medicant. Indian J Anaesth.1995; 43:133-139.

Downloads

Published

2016-07-30

Issue

Section

Original Research Articles

How to Cite

1.
A prospective randomized double blind study to compare the efficacy of oral Clonidine to intravenous Lignocaine for attenuation of haemodynamic response to laryngoscopy and tracheal intubation. Int Jour of Biomed Res [Internet]. 2016 Jul. 30 [cited 2025 Mar. 12];7(7):499-510. Available from: https://ssjournals.co.in/index.php/ijbr/article/view/3437