title: Comparision of clonidine and dexmedetomidine for attenuation of laryngoscopy and intubation response - A randomized controlled trial.
abstract: BACKGROUND
  Clonidine and dexmedetomidine are alpha-2 agonists with beneficial effect on the hemodynamic response to laryngoscopy and intubation. The present study was designed to evaluate and compare the efficacy of intravenous clonidine 1 μg/kg, and dexmedetomidine in doses of 0.5 μg/kg and 1 μg/kg, for blunting the hemodynamic changes during laryngoscopy and intubation.
  
  
  METHODS
  Adult patients of ASA physical grade I/II scheduled for surgery under general anaesthesia with endotracheal tube were randomly divided into three groups using a computer generated random number table, each group receiving one of the following drugs prior to induction of anaesthesia, by a blinded anaesthesiologist in a volume of 100 mL infused intravenously over 20 minutes: clonidine 1 μg/kg, or dexmedetomidine 0.5 μg/kg, or dexmedetomidine 1 μg/kg. General anaesthesia was induced using standard technique and intubations performed by same anaesthesiologist. Heart rate and mean blood pressure were recorded in pre-operative room (baseline) and again at 1 minute, 3 minutes, 5 minutes and 10 minutes after intubation. An increase in heart rate and/or mean blood pressure by >20% above baseline values during observation period was taken to indicate a positive intubation response.
  
  
  RESULTS
  The incidence of intubation response was similar in all three groups (P>.05). The number of patients developing hypotension was significantly higher in group receiving dexmedetomidine1μg/kg group (P<.005) as compared to other two groups. Both the groups receiving dexmedetomidine had higher number of patients developing bradycardia as compared to patients receiving clonidine.
  
  
  CONCLUSIONS
  Dexmedetomidine 0.5 μg/kg, 1 μg/kg and clonidine 1 μg/kg attenuate the laryngoscopy and intubation response but Clonidine 1 μg/kg was associated with lesser side effects.
authors.affiliation: Department of Anaesthesia & Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India. Electronic address: kakkaraanchal2@gmail.com.
authors.forename: Aanchal
authors.initials: A
authors.lastname: Kakkar
authors.affiliation: Department of Anaesthesia & Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India. Electronic address: drashatyagi@gmail.com.
authors.forename: Asha
authors.initials: A
authors.lastname: Tyagi
authors.affiliation: Department of Anaesthesia & Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India. Electronic address: nazishnabi@gmail.com.
authors.forename: Nazish
authors.initials: N
authors.lastname: Nabi
authors.affiliation: Department of Anaesthesia & Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India. Electronic address: newdraksethi@gmail.com.
authors.forename: A K
authors.initials: AK
authors.lastname: Sethi
authors.affiliation: Department of Anaesthesia & Critical Care, Presently at Maulana Azad Medival College, Delhi, India. Electronic address: ucverma2k@gmail.com.
authors.forename: U C
authors.initials: UC
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000768:Anesthesia, General; D001794:Blood Pressure; D001919:Bradycardia / Q000139:chemically induced; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use*; D020927:Dexmedetomidine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007022:Hypotension / Q000139:chemically induced; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D003000:Clonidine
keywords: Clonidine; Dexmedetomidine; Intubation; Laryngoscopy