A comparative study of IV lignocaine vs oral clonidine for attenuation of haemodynamic response to laryngoscopy and endotracheal intubation

Background: Laryngoscopy and tracheal intubation induce potentially harmful hemodynamic response. None of the advocated methods had been accepted as the most effective option. Ease of use and economical advantages of the suggested methods are also important considerations. This study was designed to address this concern by using two common drugs (intravenous lignocaine vs.oral clonidine). Material and Method: A randomized, controlled, prospective, single blind study was planned involving 70 patients divided equally into two groups – Group C (patients received oral Clonidine 4 mcg/kg 90 minutes prior to intubation) and Group L (Patients received intravenous Lignocaine 2 mg/kg 3 minutes prior to intubation). Observations: Focus was on hemodynamic parameters - Heart rate, Systolic, Diastolic, Mean blood pressures and Rate pressure product, however, sedation and anxiety score was also compared. Results: Demographic profile and time taken for intubation was same in both the groups. Post intubation rise (>25 % from base line) in heart rate was observed more in Gr.L (54.28 %) as compared to 5.71 % in Gr.C. Systolic, diastolic and mean arterial blood pressure variations were observed more in Gr L (42.85 %, 25.71 % and 22.85%) as compared to Gr. C (2.85 %, 5.71 % and 2.85 % ). Difference for all the above parameters was statistical significant (p-value < 0.05). However 40 % of patients were drowsy, 82.85 % of patients had dryness of mouth, two patients (5.71 %) had bradycardia and hypotension in Clonidine group, whereas such observations were not made in Lignocaine group. Conclusion: Oral Clonidine at a dose of 4 mcg/kg body weight (up to a maximum limit of 200 mcg) therefore can be considered as better option than time tested intravenous Lignocaine Key Words: Anaesthesia, Intubation response, Effective attenuation of laryngoscpic response, Lignocaine, Clonidine