A Comparative Study on Oral Clonidine and Gabapentin for Preoperative Anxiolysis and Attenuation of Hemodynamic response to Direct Laryngoscopy and Endotracheal Intubation

Poudel PR*, Pokharel A**, Pokharel JN***

Abstract


Introduction: Patients under going surgery experience unpleasant anxiety preoperatively that adversely influence anesthetic induction and patient recovery. Hemodynamic stability is an essential goal of any anesthetic management. The aim of this study was to compare the effects of oral Clonidine and Gabapentin in preoperative anxiolysis and attenuation of hemodynamic response to endotracheal intubation.

Method: This is a prospective, randomized, double blind clinical study. Sixty-six patients aged 18 to 60 years of American Society of Anesthesiologist (ASA) physical status I and II, scheduled for elective surgeries under general anesthesia with endotracheal intubation were included. Patients were randomized and given oral Gabapentin 800 mg (Group G) or Clonidine 300 mcg (Group C) or Placebo tablets (Group P) two hours prior to surgery accordingly. Study groups were compared for patient characteristics, Visual Analogue Scale (VAS) anxiety score and hemodynamic response at baseline, before intubation and after intubation at 0, 1, 3, 5 and 10 mins. Collected data were analyzed with Chi-square test and ANOVA with Post-hoc comparisons.

Result: VAS anxiety score was significantly decreased in group G and C as compared to Placebo (P = <0.001). But it was comparable between the group G and C. There was statistically significant difference in heart rate (HR) at 0, 1, 3 and 5 mins (P = 0.023, 0.005, 0.037& 0.037) between group G and C. Mean arterial pressure (MAP) was statistically significant at 0 min (P = 0.011) and 1 min (P = 0.036) between group G and C whereas at 3, 5 and 10 mins it was comparable. No significant side effects of study drugs were noted.

Conclusion: Oral Clonidine (300 mcg) given two hours preoperatively can effectively decrease preoperative anxiety and provide good attenuation of hemodynamic response to laryngoscopy and endotracheal intubation as compare with the oral Gabapentin (800 mg) and Placebo.

Keywords: Clonidine, Gabapentin, Hemodynamic response, Intubation, Laryngoscopy

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