Abstract
Background: Laryngoscopy and endotracheal intubation are potent stimuli that can induce increased sympathetic activity leading to tachycardia, hypertension and dysrrhythmias. Various drugs and methods have been tried to obtund this response. To obtain ideal drugs, studies still continue. We compared the efficacy of clonidine and pregabalin to attenuate the pressor response during laryngoscopy and intubation.
 Method: Total 80 patients of ASA grade I scheduled for elective surgery under general anaesthesia, were randomized into two groups. Group A received oral clonidine 300 mcg 2 hrs prior to surgery, group B received oral pregabalin 75mg 2 hrs prior to surgery. Heart rate and blood pressure (SBP, DBP &MAP) were recorded at baseline, before induction, before intubation, during laryngoscopy, 0, 1, 3, 5, and 10 minutes after intubation.
 Results: When compared to clonidine and pregabalin, there was a significant increase in HR and MAP in pregabalin after laryngoscopy and tracheal intubation. Clonidine was better than pregabalin in suppressing the pressor response.
 Conclusion: Clonidine appears to be better than Pregabalin for control of haemodynamic response to laryngoscopy and intubation besides providing sedation.
 Keywords: Clonidine, Pregabalin, hemodynamic changes and endotracheal intubation.
Highlights
Endotracheal intubation is considered to be the gold standard in airway management during general anaesthesia and in critical care settings
In our study,we compared the effect of oral clonidine and pregabalin given 120 min before the start of surgery on laryngoscopy,tracheal intubation in patients undergoing total abdominal hysterectomy.In our study boths groups were comparable with respect to age and weight and their baseline values in heart rate (HR), Systolic blood pressure (SBP),Diastolic blood pressure (DBP),Mean arterial pressure (MAP) were comparable among both groups
Bhawna Rastogi et al conducted a study to compare effect of oral pregabalin 75mg and pregabalin 150mg premedication for attenuation of pressor response to endotracheal intubation under general anaesthesia. They observed that significant increase in heart rate and mean arterial pressure was observed in pregabalin 75mg after airway instrumentation, while statistically significant attenuation of mean arterial pressure was seen in pregabalin 150mg.[22]
Summary
Endotracheal intubation is considered to be the gold standard in airway management during general anaesthesia and in critical care settings. As such endotracheal intubation is a safe and common practice in modern day anaesthesia but it can induce increased sympathetic activity leading to tachycardia, hypertension and dysarrhythmias. A change in plasma catecholamine concentrations has been demonstrated to be a part of the stress response This autonomic changes are variable, transitory, unpredictable and well tolerated in ASA I & II patients, but it may detrimental in patients with pre-existing hypertension, Cardiac disease, and cerebral pathologies.[2,3] Various non -pharmacological methods like smooth & gentle intubation with a Varsha Saini et al, International Journal of Medical and Biomedical Studies (IJMBS).
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