Key result
Oral clonidine (0.2 mg) and gabapentin (800 mg) both attenuated hemodynamic responses to laryngoscopy and intubation compared to placebo, but clonidine was significantly more effective (p<0.0001).
Why the study?
Laryngoscopy and endotracheal intubation stimulate the sympatho-adrenal system causing increases in blood pressure and heart rate, prompting comparison of oral clonidine, gabapentin, and placebo premedication to attenuate this response.
Does oral clonidine or gabapentin premedication reduce the hemodynamic response to laryngoscopy and endotracheal intubation in adults undergoing elective surgery?
RCT (n=90)
Double-blind
Computerized random table
No
Does oral clonidine or gabapentin premedication reduce the hemodynamic response to laryngoscopy and endotracheal intubation in adults undergoing elective surgery?
Oral premedication with clonidine 0.2 mg is superior to gabapentin 800 mg and placebo in attenuating the acute hemodynamic stress response to laryngoscopy and endotracheal intubation.
Answers are grounded in this paper and cite their sources.
Clonidine attenuated intubation hemodynamics more than gabapentin or placebo; leaves open optimal premedication pending larger trials.
Background: Laryngoscopy and endotracheal intubation causes stimulation of symphatho-adrenal system resulting in increase in blood pressure and heart rate. The present study compared oral clonidine, gabapentin and placebo premedication in attenuating haemodynamic response to laryngoscopy and endotracheal intubation.Methods: About 90 adult patients of ASA grade I and II patients in age group of 18-60 yrs, of either sex posted for surgery under general anaesthesia were randomly divided into three groups (30 patients in each group). The study drugs were given orally 90minutes before induction. Group 1 and Group 2 were pre treated with oral clonidine (0.2mg) and gabapentin (800mg) respectively and Group-3 received placebo. The HR, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded before induction of anesthesia and 1, 3, 5, 10min after laryngoscopy and intubation.Results: It was found that both clonidine and gabapentin reduces HR, SBP, DBP, MAP than placebo group at lminute, 3minutes, 5minutes and 10minutes after intubation. But reduction is more with clonidine as compared to gabapentine and difference was statistically significant (P = <0.0001).Conclusions: Both oral clonidine and gabapentine attenuate hemodynamic response to laryngoscopy and endotracheal intubation but effect is better with clonidine than oral gabapentine.
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Mishra et al. (2018) conducted an RCT in Patients undergoing elective surgery under general anaesthesia requiring laryngoscopy and intubation (n=90). Clonidine and Gabapentin vs. Placebo was evaluated on Hemodynamic response (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure) at 1, 3, 5, and 10 minutes post-intubation (p=<0.0001). Oral clonidine (0.2 mg) and gabapentin (800 mg) both attenuated hemodynamic responses to laryngoscopy and intubation compared to placebo, but clonidine was significantly more effective (p<0.0001).
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