Oral premedication with pregabalin or clonidine for attenuating the pressor response to laryngoscopy and tracheal intubation in laparoscopic cholecystectomy

Chandra, Alka; Yathish, SK; Gupta, Anshumali; Agarwal, DheerajNarain; Chopra, Ratna

doi:10.4103/mjdrdypu.mjdrdypu_42_18

Cited by 3 publications

(4 citation statements)

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“…They observed that clonidine (200 µg) is better in decreasing the HR as compared to pregabalin (150mg) which was statistically significant after induction and 10 min post laryngoscopy and intubation. 18 Both clonidine (200 µg) and pregabalin (150mg) provided adequate anxiolysis and sedation in preoperative period which is in accordance with studies conducted by Gupta et al, Chandra et al and Waikar et al 13,15,19…”

Section: Discussionsupporting

confidence: 82%

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

Kaur

Gupta

Singh

et al. 2021

Int J Basic Clin Pharmacol

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Background: Endotracheal intubation is associated with hemodynamic stress responses. Various drugs have been used in the past to attenuate the pressor response; however, none has been proved to be ideal. Present study was planned to evaluate the oral pregabalin 150 mg and clonidine 200 µg for attenuation of pressor response to intubation.Methods: The study was conducted on 100 adult patients of either gender scheduled to undergo elective surgeries under general anaesthesia (GA). The patients were randomly allocated into 2 groups. In group A patients received pregabalin 150mg and in group B patients received clonidine 200µg orally. The hemodynamic parameters were recorded until 10 minutes after intubation. The sedation, anxiety and side effects were also assessed.Results: In clonidine group, the mean HR remained below the baseline value at all the time intervals. In pregabalin group, the mean HR remained below the baseline value at most of the time intervals but increased above baseline just after intubation (T0i) and 1 minute after intubation (T1i) where increase was only 1.488±1.20% and 0.45±1.16% respectively from baseline. In both pregabalin and clonidine groups, the mean SBP and MAP remained below the baseline value (Tb) at all the time intervals from T0.5 to T10i. Both clonidine and pregabalin provided adequate anxiolysis and sedation with pregabalin providing more pronounced sedation and anxiolysis than clonidine.Conclusions: Both clonidine and pregabalin are effective oral premedication drugs for attenuation of the pressor response to laryngoscopy and endotracheal intubation.

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Section: Discussionsupporting

confidence: 82%

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

Kaur

Gupta

Singh

et al. 2021

Int J Basic Clin Pharmacol

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“…2 Hypertension, tachycardia, dysrhythmia, myocardial ischemia, increased circulating catecholamines and cerebral haemorrhage are some of the complications associated with laryngoscopy and intubation. 3 Many cases of difficult intubation are missed even after doing a preoperative assessment of airway. Visualizing larynx or passing endotracheal tube into glottis are the problems encountered frequently while doing tracheal intubation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation and comparison of haemodynamic response and ease of intubation between Truview PCD TM, McCOY and Macintosh laryngoscope blades

Chandra¹,

Singh²,

Agarwal³

et al. 2019

IJCA

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Introduction: Failure to secure the airway can lead to adverse cardiopulmonary events, brain damage or even anaesthetic death. The advent of various optical or video laryngoscopes have brought about a revolution in airway management. Truview PCD TM laryngoscope is a recently introduced device with a unique blade and prismatic lens which without external manipulation makes visualization of laryngeal inlet much easier. We have therefore compared glottic visualization haemodynamic response and ease of intubation between Truview PCD TM , McCoy and Macintosh laryngoscope blades. Material and Methods: Patients were randomly allocated into three groups of 40 each. Group I-Truview PCD TM laryngoscope, group II-McCoy laryngoscope and group III-Macintosh laryngoscope group. After induction patients were intubated with appropriate blade according to the group allocated. Visualization of laryngeal inlet was graded using Modified Cormack and lehane. Ease of intubation was also graded and hemodynamic parameters were noted on following occasions. Baseline (T1), before induction (T2), after induction (T3), immediately after intubation (T4), 1 min, 3 min and 5 min after intubation (T5,T6 and T7 respectively). Result: Quantitative variables were co-related using ANOVA/Kruskal Wallis test between the three groups and post hoc comparison was performed by independent T test/ Mann-Whitney test (when the data sets were not normally distributed) between the two groups. Qualitative variables were correlated using Chi-square test/Fisher's exact test. The data was entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0 (Chicago, USA). A P-value of <0.05 was considered statistically significant. There was a difference in visualization of glottis which was statistically significant between the three groups (P <0.0001). The view was best in group I compared to group II & III (P=0.024, P<0.0001 respectively). The view was however better in group II compared to group III (P<0.0001). The time for intubation was more in group I compared to group II (P<0.0001) and group III (P<0.0001). However it was more in group II compared to group III (P<0.0001). The number of attempts for intubation and need for the change of blade was comparable in all the three groups (P=NS). The heart rate was higher in group I compared to group II at T4,

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“…Our findings are in line with various previous studies who compared clonidine and pregabalin or control population and found a significantly better hemodynamic stabilization with Clonidine. [ 9 10 ] Even, the time periods at which the HR and BP were significantly different among the intervention groups were mostly similar. Gupta et al .,[ 17 ] reported hemodynamic variability after laryngoscopy with maximal rise after 1 min of laryngoscopy in the control population.…”

Section: Discussionmentioning

confidence: 94%

“…Pregabalin and clonidine are the two drugs which have been studied widely for postoperative analgesia, but there are very few studies that evaluated their use as oral premedication for attenuation of pressor response. [ 8 9 10 ]…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled study to compare hemodynamic effects between clonidine and pregabalin in laparoscopic cholecystectomy

et al. 2020

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Background: Laparoscopic cholecystectomy (LC) is associated with pneumoperitoneum and hemodynamic disturbances. Pregabalin and Clonidine have been used for anesthetic effects, but a better drug for controlling hemodynamic parameters is being investigated. Aims: The study was done to assess and compare the efficacy of preoperative single oral dose of pregabalin and clonidine in maintaining the hemodynamic parameters in the LC. Settings and Design: The prospective, interventional, randomized, comparative, single-blinded study was conducted in the department of anesthesia and surgery from January 2015 to September 2016 after taking approval from the institutional ethical committee. Materials and Methods: The study included a total of 90 patients, aged between 18 and 56 years of both sexes scheduled for elective LC. Patients were randomized into three groups of 30 each who received oral pregabalin 150 mg, clonidine 200 ug, and placebo. The hemodynamic parameters were recorded at various time intervals along with any adverse events. Statistical Analysis: Quantitative variables were compared using unpaired t -test (when the data sets were not normally distributed) between the two groups. Qualitative variables were compared using Chi-square test/Fisher's exact test. P < 0.05 was considered statistically significant. Results: There was a significant increase in the heart rate (HR) and systolic, diastolic, and mean blood pressure during laryngoscopy and pneumoperitoneum in the control group as compared to both pregabalin and clonidine. HR was significantly lower in clonidine group after extubation and in postoperative period than both control group and pregabalin group. There was no major difference in the incidence of side effects. Conclusion: Both pregabalin (150 mg) and clonidine (200 ug) were effective in controlling the hemodynamic parameters during LC, with clonidine providing better hemodynamic stability than Pregabalin.

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Oral premedication with pregabalin or clonidine for attenuating the pressor response to laryngoscopy and tracheal intubation in laparoscopic cholecystectomy

Cited by 3 publications

References 1 publication

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

Evaluation and comparison of haemodynamic response and ease of intubation between Truview PCD TM, McCOY and Macintosh laryngoscope blades

A randomized controlled study to compare hemodynamic effects between clonidine and pregabalin in laparoscopic cholecystectomy

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