BACKGROUND Laryngoscopy and tracheal intubation activate the sympathetic system resulting in tachycardia and hypertension. Alpha-2 agonists like clonidine and dexmedetomidine blunt the sympathoadrenal stimulation caused by tracheal intubation and surgery. This study aims to compare the effect of intravenous dexmedetomidine and clonidine on the stress response resulting from laryngoscopy and endotracheal intubation. METHODS This is a prospective randomized control study. Ninety adult patients of age between 18 and 55 years in American Society of Anesthesiologists physical status I and II were included in this study. Patients were randomly allocated into Group A (Placebo), Group C (Clonidine) and Group D (Dexmedetomidine) of 30 patients each. In the operation theatre, placebo (0.9% normal saline, clonidine (2 μg/kg) or dexmedetomidine (1 μg/kg) or) diluted in 20 ml NaCl 0.9% were infused over a period of 10 min. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded. Hypotension, bradycardia and sedation scores were also noted. Statistical analysis was done using Excel Data Plugin. Data is represented as mean ± standard deviation. Chi-square and two-way analysis of variance were used p < 0.05 was considered significant. RESULTS HR, SBP, DBP and MAP were significantly lower in Group C and D compared to Group A at all times after intubation. Comparing Group C and D also, there was a significant difference in HR, MAP (till 6 th minute after intubation), SBP and DBP (till 4 th minute after intubation). CONCLUSIONS Dexmedetomidine 1 μg/kg and clonidine 2 μg/kg used in blunting the laryngoscopic response produces significant reduction in HR and BP compared to placebo. But dexmedetomidine produced better attenuation of intubation response compared to clonidine with no major side effects. HOW TO CITE THIS ARTICLE: Kaliannan SK, Sherfudeen KM, Dammalapati PK. Comparison of clonidine and dexmedetomidine in blunting the cardiovascular responses to laryngoscopy and tracheal intubation-a randomized control study.