COMPARATIVE STUDY OF ORAL CLONIDINE WITH ORAL DIAZEPAM AS PREMEDICATION IN PATIENTS FOR GENERAL ANAESTHESIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 52
Abstract
BACKGROUND The sequence of induction of anaesthesia, laryngoscopy and tracheal intubation is associated with marked haemodynamic changes and autonomic reflex activity which may be a cause of concern in many high-risk patients. Objective of this study is to compare the effects of oral Clonidine with Diazepam with respect to anxiolysis, sedation, anaesthetic requirements, heart rate, blood pressure, attenuation of sympathetic responses to laryngoscopy and intubation, respiratory rate and undesirable effects. MATERIALS AND METHODS 100 ASA I and II status normotensive patients scheduled for elective surgical procedure were selected randomly and divided into two groups of 50 each. Group I received 3 µgm/kg oral Clonidine and Group II received oral Diazepam 10 mg, 90 minutes before induction of anaesthesia. Anxiolysis, sedation, anti-sialagogue effect, respiratory rate, heart rate, systolic and diastolic pressure were recorded during premedication and 90 minutes after premedication. Also, the HR, systolic, diastolic blood pressures were recorded non-invasively during induction, 1, 3, 5, 10, 15, 30 minutes from the onset of laryngoscopy. Also, the dose of thiopentone injected intravenously till the loss of eyelash reflex was calculated and any undesirable effects were looked for. RESULTS After premedication with oral Clonidine 3 µgm/kg BW, heart rate, diastolic blood pressure, respiratory rate were equally comparable to oral Diazepam, however systolic blood pressure decreased in the Clonidine group and also the dose of Inj. Thiopentone was less in Clonidine group. After intubation, the incidence of tachycardia was significantly greater in the Diazepam group than in Clonidine group. Rise in SBP and DBP were also statistically significant in Diazepam group than in Clonidine group. CONCLUSION Clonidine provides better anxiolysis without any change in the respiratory pattern when compared with Diazepam group. Oral Clonidine 3 µgm/kg provides a consistent, reliable and effective attenuation of pressor response as compared to Diazepam 10 mg
Authors and Affiliations
Yathish Nanjaiah, Moses Charles Dsouza, Rahul Fernandez, Sumithra Selvam
Postgraduate Student, Department of ENT, Chettinad Hospital and Research Institute, Kelambakkam, Tamilnadu.
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