To Evaluate the Efficacy of Oral Clonidine to Attenuate the Haemodynamic Pressor Responses Associated with Laryngoscopy and Endotracheal Intubation in Controlled Hypertensive Patients

Introduction: Laryngoscopy and ETI are powerful noxious stimuli and may have deleterious respiratory, neurological or cardiovascular effects. The cardiovascular responses to laryngoscopy and intubation includes hypertension, tachycardia, arrhythmias, in extremes of cases myocardial ischemia and cerebral hemorrhages. Patients with essential hypertension are known to exhibit exaggerated pressor responses to sympathetic stimulation as compared to normotensive patients. Hence it becomes mandatory to employ methods of attenuating these responses. Aims and Objectives: To assess the degree of cardiovascular responses to laryngoscopy and ETI in controlled hypertensive patients, effectiveness of oral clonidine in attenuating these press or responses, incidences of complications in control and clonidine group. Materials and Methods: Sixty patients aged between 18-65years k/c/o hypertension on antihypertensive medications scheduled for elective surgical procedures belonging to ASA class II will be randomly allocated in two groups. Group C will receive Clonidine 100 mcgtablet and Group P will receive Saccharide tablet 90 minutes before intubation. Both groups will be observed for changes in HR, SBP, DBP and MAP, before, during, immediately after ETI and at 2, 5, 7, 10 minutes after ETI. Result: There was statistically significant rise in HR, SBP, DBP and MAP in control group as compared to Clonidine group, with return to basal values after 3 minutes in Clonidine group. Clinical relevance: Premedication with oral clonidine provided stable haemodynamics in hypertensive patients and decreased critical time after intubation in which patient is prone to cardiovascular complications.