Comparison of Fentanyl and Clonidine for Attenuation of the Haemodynamic Response to Laryngocopy and Endotracheal Intubation
ABSTRACT Introduction: Laryngoscopy and tracheal intubation after the induction of anaesthesia, are nearly always associated with a sympathetic hyperactivity. To ‘blunt’ this pressor response, various methods have been tried, but very few studies have been done to assess the effects of fentanyl...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2013-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/2682/27-%204988_E(C)_PF1(M)_F(P)_OLF(P)_U(P).pdf |
| Summary: | ABSTRACT
Introduction: Laryngoscopy and tracheal intubation after the
induction of anaesthesia, are nearly always associated with a
sympathetic hyperactivity. To ‘blunt’ this pressor response, various methods have been tried, but very few studies have been
done to assess the effects of fentanyl orI.V. clonidine on the haemodynamic response during laryngoscopy and tracheal intubation. The purpose of this study was to compare these agents,
to find the drug which was best suited for this purpose and the
most favourable time for its administration.
Methods: This was a prospective study which involved 3 groups
of patients. The patients in group-1 (control) were given normal
saline and the groups 2 and 3 were given i.v. fentanyl and clonidine respectively. Each group had 50 patients who presented
for elective, non-cardiovascular surgeries. All the patients were
ASA-1 or ASA-II and were operated in PESIMSR, Kuppam.
Results: The heart rate rise was 48.07% in the control group,
whereas it was significantly lower in the fentanyl (II) 27.75%
and the clonidine groups (III) 12.57% (p<0.001). In the control
group, the systolic blood pressure increased maximally after 5
minutes (42.62%) i.e., immediately after the laryngoscopy and
the intubation. It decreased gradually over 10 minutes (17.39%).
With the administration of fentanyl, the maximum increase as
compared to the preinduction value was 9.91%, but it was only
7.38% in the clonidine group. Both, when they were compared
with the control, showed a significant suppression (P<.001),
with clonidine showing better results. The maximum increase
in the diastolic blood pressure was 30.12% in the control group
(P<.001) at 5 min and it was 18.22%, and 6.15% in the fentanyl
and the clonidine groups respectively, with clonidine faring better again (P<.001).
Interpretation and Conclusion: Clonidine showed better attenuation of the sympathetic response, which is statistically
highly significant and it remained so till the end of 10 minutes.
Intravenous clonidine 2µg/kg which is administered 5 minutes
before the laryngoscopy can be recommended to attenuate the
sympathetic response to the laryngoscopy and the intubation. |
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| ISSN: | 2249-782X 0973-709X |