Intravenous Clonidine with Lignocaine Nebulization to Attenuate the Hemodynamic Response to Laryngoscopy and Tracheal Intubation: A Comparative Study

Abstract

Introduction:The present study was conducted to compare the efficacy of intravenous (i.v.) clonidine with that of lignocaine nebulization for attenuation of pressor response to laryngoscopy and tracheal intubation. Materials and methods: Fifty patients of either sex aged between 18 years and 60 years covered under American Society of Anesthesiologists health status classes I and II, undergoing elective surgery under general anesthesia requiring endotracheal intubation, were considered. Patients were randomly divided into two groups. Group A received i.v. clonidine 1 μg per kg and nebulization with 3 mg per kg of 4% lignocaine, and group B received i.v. normal saline and nebulization with 3 mg per kg of 4% lignocaine before intubation. Hemodynamic parameters were noted at baseline, after giving study drug, every minute after intubation for 10 minutes and then every 10 minutes thereafter till the end of the surgery. Results: It was noted that in group A, the rise of HR, SBP, DBP, and MAP 1 minute after intubation was found to be 85.4 bpm, 117.5, 70.6, and 86.2 mm Hg, and in group B, the rise of HR, SBP, DBP, and MAP 1 minute after intubation was found to be 93.9 bpm, 129.9, 85.2, and 100.1 mm Hg, respectively. Nebulized lignocaine was not found effective in attenuating hemodynamic response to intubation, and hemodynamic parameters were significantly high after intubation as compared to clonidine group. Conclusion:In our study, i.v. clonidine in a dose of 1 µg per kg administered 15 minutes before laryngoscopy, and intubation was far superior to nebulized lignocaine alone in attenuation of the hemodynamic response.