Comparison Between Oral Gabapentin and Oral Clonidine as Premedicant in Obtunding Haemodynamic Response to Laryngoscopy and Endotracheal Intubation

Abstract

Introduction: Effects of laryngoscopy and endotracheal intubation have been studied for more than half a century. Various experiments in this regard have guided modern medical and anaesthesiological practice to safeguard patients undergoing surgery under general anaesthesia. Premedication with drugs to attenuate the sympathoadrenal response caused by this procedure, to facilitate a smooth induction and maintainence of general anaesthesia with minimal hemodynamic alterations have shown good results. Clonidine and Gabapentin are two of such drugs that we considered comparing in our study; both having multiple pharmacological benefits providing effective results.

Objectives: The aim of our study was to compare the efficacy of oral gabapentin versus oral clonidine as premedication with respect to the haemodynamic response during laryngoscopy and endotracheal intubation.

Methods: A prospective randomized double blind study was conducted on a total of 200 patients undergoing elective surgery under general anaesthesia after institutional ethical committee approval and patient informed consent. Randomly assigned into two equal groups of 100 each, Group G received 600mg of oral gabapentin and Group C received 200μg of oral clonidine 90 minutes prior to start of surgery with sips of water. The preoperative sedation and anxiety scores and pulse rate, systolic, diastolic blood pressure and mean arterial pressures, side effects, if any were noted.

Results: Oral Clonidine 0.2mg when compared with oral gabapentin 600 mg caused better attenuation of haemodynamic response to laryngoscopy and tracheal intubation. Clonidine also maintained a significantly lower pulse rate throughout the study period.

Conclusions: 0.2mg clonidine and 600mg gabapentin both proved to be good premedicant drugs for general anaesthesia as well as in maintaining the sedation and anxiety scores. 0.2mg clonidine proved to be statistically better in attenuating the pressor response to laryngoscopy and tracheal intubation.