A Comparative Study of Oral Clonidine and Intravenous Fentanyl in Attenuation of The Hemodynamic Responses to Laryngoscopy and Endotracheal Intubation inaTertiaryCare Hospital
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 4, Pages 199-210
AbstractIn anaesthesia, circulatory stimulation during tracheal intubation are caused by the stimulation of laryngeal and tracheal tissues from both direct laryngoscopy and placement of the ET tube in the trachea. These stimuli often evoke sympathoadrenal responses characterized by changes in Blood pressure, Heart rate, Cardiac rhythm, ST segment changes, and may lead to pulmonary oedema and rupture of cerebral aneurysm. In the present study that was carried out in the Institute, we compared the efficacy of Oral Clonidine versus Intravenous Fentanylin attenuating the cardiovascular stress response to laryngoscopy and tracheal intubation.
Material and Methods: The present Prospective and Comparative study was carried out at a Tertiary Care Hospital amongst 100 patients those who were randomly allocated to two groups, Group C: Patients in this group received- 5 microgram/kg of Oral Clonidine with 2 sips of water 90 minutes prior to surgery. Group F: Patients in this group received 100ml of normal saline over 10 minutes and 2 microgram /kg of fentanyl in 5ml of normal saline, 5 minutes prior to laryngoscopy and intubation.
Results: Out of 100 subjects, 32% subjects were in the age group 21 to 30 years and 22% in 41 to 50 years. The mean heart rate during Laryngoscopy in the groups Fentanyl and Clonidine were 108.58 and 91.56 respectively. The mean SBP during Laryngoscopy in the groups Fentanyl and Clonidine was 139.84 and 124.78 respectively and the mean SBP at 1 minute after intubation was 137.14 and 121.94 respectively. The mean DBP during laryngoscopy in the groups Fentanyl and Clonidine were 91.18 and 82.68. and at 1 minute after intubation, it was 88.36 and 78.52 respectively. The mean MAP at 1 minute after intubation in the groups Fentanyl and Clonidine were 101.54 and 92.98 respectively
Conclusion: Oral Clonidine 5 μg/kg proved to keep the hemodynamics in stable manner during laryngoscopy and endotracheal intubation and up to 30 mins post-intubation. Fentanyl in the dosage of 2 μg /kg given 5 minutes before laryngoscopy and intubation attenuated the hemodynamic changes, but was not equally effective in reducing the increase in heart rate and blood pressure.
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