Dexmedetomidine and clonidine as premedication in attenuation of sympathetic response during laryngoscopy and tracheal intubation in hypertensive patients undergoing open cholecystectomy- an open level randomised control trial

Author: 
Sourav Saha., Biswajit Sutradhar and Dipanka Debnath

Introduction: Laryngoscopy and tracheal intubation are often associated with tachycardia, hypertension and arrhythmias. It is because of the sympathetic adrenergic outflow caused by laryngeal tissue stimulation. The present study is designed to compare the effect of dexmedetomidine and clonidine administration on the sympathetic response prior to induction among hypertensive patients undergoing laryngoscopy and endotracheal intubation during open cholecystectomy. Method: A randomized double blinded study was conducted among 60 adult patients according to inclusion and exclusion criteria. They were randomly distributed into two groups (30 patients each). One group received Inj. Dexmedetomidine 0.5mcg/kg iv diluted in 100 ml normal saline over 15 mins. Another group received Inj. Clonidine 3mcg/kg IV diluted in 100 ml normal saline over 15 mins. Result: In this study the mean SBP, DBP, MAP after 1 min and 5 mins of laryngoscopy of patients were significantly higher in patients who received Clonidine compared to patients who received Dexmedetomidine. However no statistically significant difference was observed in heart rate. Rescue Medication was required more in clonidine group as compared to dexmedetomidine group though the difference was not statistically significant. Conclusion: It is concluded that both the drugs- Dexmedetomidine & Clonidine, are safe and recommended for attenuation of pressor response during laryngoscopy and tracheal intubation. Dexmedetomidine is more effective in attenuating the hemodynamic response to laryngoscopy & tracheal intubation in hypertensive patients undergoing open cholecystectomy than Clonidine.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.1985.1434
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