Comparative study of oral clonidine and oral gabapentin in attenuation of pressor response to direct laryngoscopy and tracheal intubation

Abstract

Background: Laryngoscopy and intubation causes reflex sympatho-adrenal response in the form of tachycardia and hypertension. The hemodynamic responses during laryngoscopy and endotracheal intubation should be abolished to balance the myocardial oxygen supply and demand which is a key note in the safe conduct of anaesthesia. The present study compared the effect of oral clonidine with oral gabapentin for attenuating hemodynamic pressor responses to laryngoscopy and tracheal intubation. Methods: Total ninety patients of ASA grade I and II, age between 18-50 years, BMI 18 to 25 and who were posted for elective surgeries under general anesthesia were selected for the study. They were divided into three groups of 30 patients in each. Group P received oral placebo (control), group –C received 0.2mg of oral clonidine and group G received 800mg oral gabapentin. Heart rate, systolic blood pressures, diastolic blood pressures mean blood pressures and rate pressure product were noted before induction, after induction, during laryngoscopy and 1,2,3,4,5,10 and 15 minutes after laryngoscopy and intubation. Results: There was significant rise in hemodynamic parameters after laryngoscopy and intubation. Oral clonidine (0.2 mg) and oral gabapentin (800 mg) when given 90mins prior to surgery effectively attenuated the rise in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product to laryngoscopy and intubation as compared to oral Placebo. Conclusion: Both the drugs, tablet  clonidine 0.2mg and capsule  gabapentin 800mg when given orally  was found to be safe and without any side effects like hypotension and bradycardia.