Study between clonidine and dexmedetomidine in attenuation of pressor response during endotracheal intubation

Background: Laryngoscopy and endotracheal intubation, which are a basic and integral part of general anesthesia (GA), are associated with reflex sympathetic stimulation, manifested by tachycardia and hypertension. Aim: The aim was to compare the effect of dexmedetomidine and clonidine on the pressor response among patients undergoing tracheal intubation in elective surgeries under general anesthesia. Materials and methods: A prospective and randomized control study conducted in 80 adult patients of age 18-55 years in ASA I and II were included in this study. Patients were divided into Group D and Group C of 40 patients each. Results: Mean SBP, DBP and MAP in the dexmedetomidine group remained close to the baseline throughout the study period showing a significant difference from clonidine groups following the induction interval. In present study after intubation heart rate, SBP, and DBP was increased in all patients but the increase was more in patients of clonidine group when compared to dexmedetomidine group. There was statistically significant difference in heart rate between the two groups at 1, 3 and 4 min interval after intubation (p value<0.05). No significant changes in peripheral oxygen saturation (SpO2) and cardiac rhythm (ECG) were observed in any patients of both groups. Bradycardia (HR<50/min) was observed in one patient of dexmedetomidine group and two patients in clonidine group, five minutes after intubation. Intraoperative hypotension was observed in one patient of dexmedetomidine group and in two patients of clonidine group. Conclusion: Premedication with dexmedetomidine can safely be recommended for attenuation of provided more stable hemodynamics response to endotracheal intubation.