A prospective study comparing the efficacy of intravenous clonidine with intravenous dexmedetomidine in attenuating the haemodynamic stress response during laryngoscopy and endotracheal intubation

Introduction: Laryngoscopy and endotracheal intubation are noxious stimuli capable of producing tachycardia, arrhythmias and hypertension. This study was being done to compare the effectiveness of a pre-induction dose of clonidine with dexmedetomidine administered by intravenous infusion inattenuating the haemodynamic stress responses resulting from laryngoscopy and endotracheal intubation. Materials and Methods: Sixty adult patients included in this study were randomly divided into two groups, namely, Group A (Clonidine 4 mcg/kg) & Group B (Dexmedetomidine 1 mcg/kg) using computer generated random allocation chart and haemodynamic parameters were analyzed and recorded quantitatively from preoperative period to 30 mins post – intubation period. In the immediate post operative period and 2 hours after surgery, patient's recovery was assessed with ALDRETE recovery score and BRUSSEL'S sedation score. Results: Mean heart rate showed fall following dexmedetomidine or clonidine infusion (19% and 23% respectively from the baseline) which was clinically significant in clonidine group but was statistically not significant in both the groups (p>0.05), while the increase in Mean heart rate following intubation was 8% and 10% respectively. In the current study, there was fall in blood pressure following infusion of study drug which was clinically not significant.Following tracheal intubation, maximal average increase was 5% in systolic and 3% in diastolic blood pressure in dexmedetomidine group, as compared to clonidine group in which, it was 6% and 4%, respectively. Isoflurane consumption, propofol requirement and opioid requirement throughout the intraoperative period was reduced in both the Groups. Aldrete recovery score and Brussels sedation score were calculated and found better in group B as compared to group A. Patients were sedated but arousable. Conclusion: Based on our study we conclude that both clonidine and dexmedetomidine are equally effective in attenuating the pressor response caused by laryngoscopy and tracheal intubation.