A Comparative Study of Fentanyl –Clonidine and Fentanyl - Lidocaine on Attenuation of Haemodynamic Stress Response to Laryngoscopy and Tracheal Intubation in Hypertensive Patients

Abstract

Introduction: Endotracheal intubation may create a period of hemodynamic instability in normotensive patients but more so in hypertensive patients. Endotracheal intubation produces stimulation of laryngeal and tracheal sensory receptors, resulting in a marked increase in the elaboration of sympathetic amines leading to hypertensive crisis. Objectives: The objective of study is to evaluate and compare the efficacy of fentanyl- clonidine and fentanyl – lidocaine combine in attenuating the stress responses to laryngoscopy and endotracheal intubation in hypertensive patients. Material and Methods: We conducted a prospective, randomized, double-blind study in 40 patients with controlled hypertension. All patients were randomly divided into two groups, fentanyl-clonidine (FC) group and fentanyl – lidocaine (FL) group. The FC group received Fentanyl 2 mcg/kg and clonidine 2mcg/kg and the FL group received lidocaine1.5mg/kg and fentanyl 2mcg/kg , 3 min prior to intubation. Hemodynamic parameters were recorded at baseline, before giving induction agents, and 1, 3 and 5 minutes after endotracheal intubation. Results: There were no significant differences between the two groups regarding hemodynamic parameters like heart rate, systolic blood pressure, diastolic and mean arterial blood pressure at before induction, 1, 3 and 5 minutes after intubation. Conclusions: Both fentanyl – clonidine and fentanyl – lidocaine combine effectively decreased the stress response to endotracheal intubation.