Indian Journal of Clinical Anaesthesia


Attenuation of haemodynamic response to intubation with oral clonidine and oral atenolol


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Author Details: Vijaya Rekha Koti, Sharat Babu Chevuri, Sunil Pulla, Varunchander G

Volume : 3

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 251

Article End Page : 256


Abstract

A comparative study is done between oral Atenolol and oral Clonidine in the attenuation of cardiovascular response during laryngoscopy and intubation. 50 adult patients undergoing various elective surgeries of ASA grade 1, Mallampatigrade 1 were selected and informed consent was taken for all the cases. Patients were of both sexes and age ranging from 18 to 60 years. The study was done in two groups. Group 1 consisted of 25 patients where atenolol 0.75mg per kg body wt was given orally 3 hrs before the scheduled time of the surgery. Group 2 consisted of 25 patients where clonidine 3 micrograms per kg body wt was orally given 90min before schedules time of surgery. The drugs given in premedication were inj.glycopyrollate 10mcg/kg, inj. midazolam 40mcg/kg and inj.ondansetron 0.08mg/kg. Induction of anesthesia was achieved by inj. thiopentone in a dose of 5mg/kg iv. Tracheal intubation was facilitated with inj. suxamethonium 2 mg/kg iv.Hemodynamic parameters(BP, HR, MAP) were recorded at the  intervals of  Pre induction, After induction, During laryngoscopy and intubation, 1 min, 3 min, 5 min after intubation. Data was compared between the two groups of patients.
Group 1 did not show a significant increase in various hemodynamic parameters. Group 2 showed higher increase in hemodynamic parameters compared to oral atenolol. Hemodynamic parameters returned to the baseline at the end of 5 min in the atenolol group whereas it took more than 5 min to return to the basal value and it has less effect on the heart rate in clonidine group compared to atenolol group. The following conclusion can be drawn from our study. Oral atenolol attenuates the increase in heart rate to laryngoscopy and intubation more effectively than oral clonidine. Oral atenolol blunts the increase in systolic, diastolic and mean arterial pressure effectively and values returned to basal value within 5 min of intubation compared to oral clonidine. No side effects were noted in atenolol and clonidine groups in our study. Hence oral atenolol in a dose of 0.75 mg/kg given 3 hrs before induction of anaesthesia is effective in attenuating hemodynamic response to laryngoscopy and endotracheal intubation when compared to oral clonidine.

Keywords:
Oral clonidine, Oral atenolol, Intubation response, Laryngoscopy