Comparision of clonidine and dexmedetomidine for attenuation of laryngoscopy and intubation response – A randomized controlled trial

• Published in: Journal of clinical anesthesia Vol. 33; pp. 283 - 288
• Main Authors: Kakkar, Aanchal, MD, Tyagi, Asha, MD, DNB, Nabi, Nazish, DA, Sethi, A.K., MD, DA, Verma, U.C., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2016; Elsevier Limited
• Subjects: Adolescent; Adrenergic alpha-2 Receptor Agonists - adverse effects; Adrenergic alpha-2 Receptor Agonists - therapeutic use; Adult; Anesthesia; Anesthesia & Perioperative Care; Anesthesia, General; Blood Pressure; Bradycardia - chemically induced; Cardiac arrhythmia; Clonidine; Clonidine - adverse effects; Clonidine - therapeutic use; Dexmedetomidine; Dexmedetomidine - adverse effects; Dexmedetomidine - therapeutic use; Double-Blind Method; Drug dosages; Female; Heart Rate; Humans; Hypertension; Hypnotics and Sedatives - adverse effects; Hypnotics and Sedatives - therapeutic use; Hypotension - chemically induced; Intubation; Intubation, Intratracheal - adverse effects; Laryngoscopy; Laryngoscopy - adverse effects; Male; Middle Aged; Pain Medicine; Patients; Young Adult; Clonidine; Intubation; Dexmedetomidine; Laryngoscopy
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2016.04.026

Abstract Background Clonidine and dexmedetomidine are alpha-2 agonists with beneficial effect on the hemodynamic response to laryngoscopy and intubation. The present s tudy was designed to evaluate and compare the efficacy of intravenous clonidine 1 μg/kg, and dexmedetomidine in doses of 0.5 μg/kg and 1 μg/kg, for blunting the hemodynamic changes during laryngoscopy and intubation. Method Adult patients of ASA physical grade I/II scheduled for surgery under general anaesthesia with endotracheal tube were randomly divided into three groups using a computer generated random number table, each group receiving one of the following drugs prior to induction of anaesthesia, by a blinded anaesthesiologist in a volume of 100 mL infused intravenously over 20 minutes: clonidine 1 μg/kg, or dexmedetomidine 0.5 μg/kg, or dexmedetomidine 1 μg/kg. General anaesthesia was induced using standard technique and intubations performed by same anaesthesiologist. Heart rate and mean blood pressure were recorded in pre-operative room (baseline) and again at 1 minute, 3 minutes, 5 minutes and 10 minutes after intubation. An increase in heart rate and/or mean blood pressure by > 20% above baseline values during observation period was taken to indicate a positive intubation response. Results The incidence of intubation response was similar in all three groups (P > .05). The number of patients developing hypotension was significantly higher in group receiving dexmedetomidine1μg/kg group (P < .005) as compared to other two groups. Both the groups receiving dexmedetomidine had higher number of patients developing bradycardia as compared to patients receiving clonidine. Discussion & Conclusion Dexmedetomidine 0.5 μg/kg, 1 μg/kg and clonidine 1 μg/kg attenuate the laryngoscopy and intubation response but Clonidine 1 μg/kg was associated with lesser side effects.