A Comparative Study on Oral Clonidine and Gabapentin for Preoperative Anxiolysis and Attenuation of Hemodynamic Response to Direct Laryngoscopy and Endotracheal Intubation.

  • PR Poudel Consultant Anesthesiologist, NAMS, Bir Hospital,
  • A Pokharel Assistant Professor, NAMS, National Trauma Center,
  • JN Pokharel Professor, Sahid Gangalal National Heart Center


Introduction: Patients under going surgery experience unpleasant anxiety preoperatively thatadversely influence anesthetic induction and patient recovery. Hemodynamic stability is an
essential goal of any anesthetic management. The aim of this study was to compare the effectsof oral Clonidine and Gabapentin in preoperative anxiolysis and attenuation of hemodynamic
response to endotracheal intubation.
Method: This is a prospective, randomized, double blind clinical study. Sixty-six patients aged 18to 60 years of American Society of Anesthesiologist (ASA) physical status I and II, scheduled for
elective surgeries under general anesthesia with endotracheal intubation were included. Patientswere randomized and given oral Gabapentin 800 mg (Group G) or Clonidine 300 mcg (Group C)
or Placebo tablets (Group P) two hours prior to surgery accordingly. Study groups were comparedfor patient characteristics, Visual Analogue Scale (VAS) anxiety score and hemodynamic responseat baseline, before intubation and after intubation at 0, 1, 3, 5 and 10 mins. Collected data wereanalyzed with Chi-square test and ANOVA with Post-hoc comparisons.
Result: VAS anxiety score was significantly decreased in group G and C as compared to Placebo(P = <0.001). But it was comparable between the group G and C. There was statistically significant
difference in heart rate (HR) at 0, 1, 3 and 5 mins (P = 0.023, 0.005, 0.037& 0.037) between groupG and C. Mean arterial pressure (MAP) was statistically significant at 0 min (P = 0.011) and 1 min
(P = 0.036) between group G and C whereas at 3, 5 and 10 mins it was comparable. No significantside effects of study drugs were noted.
Conclusion: Oral Clonidine (300 mcg) given two hours preoperatively can effectively decreasepreoperative anxiety and provide good attenuation of hemodynamic response to laryngoscopy
and endotracheal intubation as compare with the oral Gabapentin (800 mg) and Placebo.
Key words: Clonidine, Gabapentin, Hemodynamic response, Intubation, Laryngoscopy

Original Article