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Intravenous Clonidine in Attenuation of Haemodynamic Responses to Laryngoscopy and Intubation

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Background: Now days, more and more patients with cardiovascular disorders are presenting themselves for surgery so anaesthesiologists are in search of safe and efficient drugs and techniques which can prevent cardiovascular responses due to laryngoscopy and intubation. Clonidine possesses beneficial effects on haemodynamics during stressful conditions like laryngoscopy and endotracheal intubation. We undertook this study to compare the effect of different doses of clonidine in attenuating the presser response to laryngoscopy and intubation in patients posted for elective surgery under general anaesthesia. Materials and Methods: This prospective randomized double blind controlled study was conducted on ASA Physical Status I and II patients in the age group of 20–60 years of either sex, scheduled for elective noncardiac surgeries under general anaesthesia requiring endotracheal intubation. Group A received 20 ml normal saline IV as infusion over 15 min whereas Group B, C and D received IV Clonidine 1, 2 and 3 µg/kg respectively, diluted to 20 ml with normal saline as infusion over 15 min. The parameters recorded were HR, SBP, DBP and MAP at 1,2,3,5,10 and 20 min after intubation. Postoperatively, heart rate, blood pressure, oxygen saturation (SpO2) and sedation level were noted at 1 hour interval for 6 hours. Results were compiled and statistically analysed. Results: After laryngoscopy and intubation, the mean heart rate and blood pressure (SBP, DBP and MAP) showed a much lesser increase in clonidine treated groups B and C as compared to control group A and this was dose related. In clonidine treated group D, the mean pulse rate and blood pressure even did not show any rise despite the stimulus of laryngoscopy and intubation and remained near the basal value throughout the study period but this was clinically not worrisome and did not required any therapeutic intervention. The heart rate and blood pressure (SBP, DBP and MAP) returned to baseline values much earlier at 5 and 2 minutes in clonidine treated groups B and C respectively. Patients in all the three clonidine treated groups showed a dose related higher level of sedation as compared to control group. Conclusion: Clonidine at all the three different doses not only attenuated the intensity of haemodynamic responses to laryngoscopy and endotracheal intubation but also decreased the duration of the response. The effect of clonidine was clearly protective and was dose related.

Perspectives

Background: Now days, more and more patients with cardiovascular disorders are presenting themselves for surgery so anaesthesiologists are in search of safe and efficient drugs and techniques which can prevent cardiovascular responses due to laryngoscopy and intubation. Clonidine possesses beneficial effects on haemodynamics during stressful conditions like laryngoscopy and endotracheal intubation. We undertook this study to compare the effect of different doses of clonidine in attenuating the presser response to laryngoscopy and intubation in patients posted for elective surgery under general anaesthesia. Materials and Methods: This prospective randomized double blind controlled study was conducted on ASA Physical Status I and II patients in the age group of 20–60 years of either sex, scheduled for elective noncardiac surgeries under general anaesthesia requiring endotracheal intubation. Group A received 20 ml normal saline IV as infusion over 15 min whereas Group B, C and D received IV Clonidine 1, 2 and 3 µg/kg respectively, diluted to 20 ml with normal saline as infusion over 15 min. The parameters recorded were HR, SBP, DBP and MAP at 1,2,3,5,10 and 20 min after intubation. Postoperatively, heart rate, blood pressure, oxygen saturation (SpO2) and sedation level were noted at 1 hour interval for 6 hours. Results were compiled and statistically analysed. Results: After laryngoscopy and intubation, the mean heart rate and blood pressure (SBP, DBP and MAP) showed a much lesser increase in clonidine treated groups B and C as compared to control group A and this was dose related. In clonidine treated group D, the mean pulse rate and blood pressure even did not show any rise despite the stimulus of laryngoscopy and intubation and remained near the basal value throughout the study period but this was clinically not worrisome and did not required any therapeutic intervention. The heart rate and blood pressure (SBP, DBP and MAP) returned to baseline values much earlier at 5 and 2 minutes in clonidine treated groups B and C respectively. Patients in all the three clonidine treated groups showed a dose related higher level of sedation as compared to control group. Conclusion: Clonidine at all the three different doses not only attenuated the intensity of haemodynamic responses to laryngoscopy and endotracheal intubation but also decreased the duration of the response. The effect of clonidine was clearly protective and was dose related.

Red Flower Publication Publications
Red Flower Publication Pvt Ltd

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This page is a summary of: Comparative Evaluation of Different Doses of Intravenous Clonidine in Attenuation of Haemodynamic Responses to Laryngoscopy and Intubation, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.43.
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