Comparative Study of Oral Clonidine Versus Gabapentin as Premedication for Anxiolysis, Sedation and Attenuation of Pressor Response to Laryngoscopy and Tracheal Intubation

Abstract

Background and Aims: We conducted a prospective, randomized, double-blind and controlled trial to compare the effects of oral clonidine and gabapentin as premedication in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery. We also compared the preoperative anxiety and sedation status between these two drugs.Materials and Methods: A total of 60 patients of American Society of Anesthesiologists (ASA) physical status I, aged 20 -50 years of either sex enrolled in the study were randomly divided into two groups of 30 each. Group A patients received oral clonidine 200 mcg and Group B patients received oral gabapentin 900 mg, 90 minutes prior to induction of anesthesia. The heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed and recorded pre and post endotracheal intubation. Anxiety and sedation score were noted after 60 minutes of oral administration of drug as well as before induction of anesthesia.Results: Both groups were matched for age, sex, weight and intubation time. Anxiety score and sedation score before induction were significantly better in clonidine group as compared with gabapentin group. Also oral clonidine attenuated the increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure better than oral gabapentin (p<0.05).Conclusion: Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin. Also clonidine is better agent as anxiolytic and sedative than gabapentin.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 131-136

A Prospective Randomized Single-Blind Study Comparing Alprazolam Versus Clonidine and Pregabalin as Preanaesthetic Medication in Patients Undergoing Elective Lower Limb Surgeries

“…Hossain et al conducted a comparative study of oral clonidine versus gabapentin as premedication for anxiolysis, sedation, and attenuation of pressor response to laryngoscopy and tracheal intubation. The result of this study revealed that 46% of patients complained of dry mouth[13]. Nasr et al revealed that the patients receiving pregabalin did not complain of any other adverse effects, and it was proved that pregabalin is well tolerated and associated with dose-dependent adverse effects that are mild-to-moderate and are usually transient[10].…”

“…Bugbee et al revealed that the use of oral anxiolytic medication before breast CNB can significantly reduce anxiety women experience during the procedure[7].Khanna et al showed that melatonin was more sedative than pregabalin and alprazolam in patients undergoing laparoscopic surgery but all the three Groups M, P, and A had comparable perioperative anxiety, post-operative analgesia[12]. Hossain et al found that clonidine is a better agent as an anxiolytic and sedative than gabapentin[13]. The result of our study was in co-relation to the study result of Bugbee et al,Khanna et al, and Hossain et al In this study, we have observed that A, C, and P groups produced a significant decrease in the anxiety status of the patient as seen by the CGI scale post-drug.…”

Efficacy of preoperative oral gabapentin for patients undergoing intracranial surgery: Effect on laryngoscopic stress response

“…Recently, gabapentin was successfully used to attenuate the hemodynamic stress response to endotracheal intubation [5].…”