Benefits of IV Clonidine as Premedication on the Hemodynamic Response during Laryngoscopy and Tracheal Intubation

Author(s): Nga Nomo S, Iroume C, Kuitchet Aristide, Djomo Tamchom D, Jemea B, Nkoumou S, Binam F, Ze Minkande J.

Background: Clonidine is an alpha-2 adrenergic agonist which decreases the release of catecholamines at the level of the centers of regulation of blood pressure, and decreases sympathetic tone and the release of circulating catecholamines.

Patients and methods: This was a randomized single-blind clinical trial that took place over a period of 4 months. All adults classified as ASA I and II admitted for scheduled surgery and requiring general anesthesia were included. The patients were randomly divided into two groups: group A (clonidine) and group B (non-clonidine). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were observed at the following times: at the pre-anaesthetic consultation (t1), at installation on the operating table (t2), 5 minutes after clonidine infusion (t3), 1st, 3rd and 5th minute after tracheal intubation (t4, t5, t6), 1st, 3rd and 5th minute after surgical incision (t7, t8, t9).

Results: During the study period, 35 met the inclusion criteria: i.e. 20 patients for group A and 15 patients for group B. In group A, the systolic and diastolic arterial pressures decrease gradually from t3 to t6 and remain very close to the baseline values of the anesthesia consultation. In group B, there is a tendency to increase systolic and diastolic blood pressure compared to baseline values at the same times. Tachycardia is found in group B while a tendency to bradycardia is encountered in group A from t3 to t6.

Conclusion: Clonidine helps to control sympathetic hyperactivity, arterial hypertension and reflex tachycardia, induced by tracheal intubation.

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