Comparative Study of Gabapentin, Clonidine and Placebo in Alleviating the Hemodynamic Changes Due to Tracheal Intubation and Laryngoscopy

Cureus. 2023 Apr 20;15(4):e37898. doi: 10.7759/cureus.37898. eCollection 2023 Apr.

Abstract

Introduction: Hemodynamic changes during laryngoscopy and tracheal intubation must be reduced for safe and effective anesthesia. The present study was conducted to compare the efficacy of oral clonidine, gabapentin and placebo in alleviating the hemodynamic changes due to tracheal intubation and laryngoscopy.

Methods: This was a double-blinded randomized controlled trial conducted on 90 patients who were undergoing elective surgery and were randomized into three groups. Group I (n=30) received a placebo, group II (n=30) received gabapentin and group III (n=30) received clonidine as premedication before anesthesia induction. Patient heart rate and pressor response were recorded periodically and compared between the groups.

Results: There was no significant difference in the baseline heart rate (HR) and mean arterial pressure (MAP) between the groups. HR elevation was observed in all three groups and found to be significant (p=0.0001) but the increase was higher in the placebo (15 min: 80.80± 15.41) and lower in the clonidine group (15 min: 65.53± 12.43). The elevation in systolic and diastolic blood pressure was least and transient in the gabapentin group, as compared to placebo and clonidine group. Intra-operatively, the requirement of opioids was higher in the placebo as compared to clonidine and gabapentin (p < .001).

Conclusion: Clonidine and gabapentin were effective in reducing the hemodynamic changes during laryngoscopy and intubation.

Keywords: clonidine; gabapentin; hemodynamic changes; laryngoscopy; premedication; tracheal intubation.