2025, Vol. 8, Issue 4, Part B
Comparative evaluation of the clonidine and dexmedetomidine on hemodynamic stability in elective surgeries
Author(s): Nishant Bhandari and Pradeep Kumar Rajbhandari
Abstract: Background: Laryngoscopy and endotracheal intubation are associated with significant sympathetic stimulation, leading to transient increases in heart rate (HR) and blood pressure. Attenuation of these hemodynamic responses is crucial to reduce perioperative cardiovascular risks. Clonidine and dexmedetomidine, both ?2-adrenergic agonists, have been used for premedication to achieve this effect. The study aimed to compare the efficacy of intravenous clonidine and dexmedetomidine in controlling hemodynamic responses during laryngoscopy and endotracheal intubation in patients undergoing elective surgeries. A prospective, comparative, analytical study was conducted in the Department of Anaesthesiology, Kirtipur Hospital, Nepal, over one year. A total of 48 patients (ASA I & II, aged 18-60 years) scheduled for elective surgery under general anaesthesia were randomly divided into two groups: Group C received clonidine 1 ?g/kg, and Group D received dexmedetomidine 1 ?g/kg, both infused over 10 minutes prior to induction. HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, after drug infusion, post-induction, and at multiple intervals following intubation. Incidences of adverse effects, including hypotension, hypertension, bradycardia, tachycardia, postoperative nausea and vomiting (PONV), and sedation, were also documented. Baseline demographic and clinical characteristics were comparable between groups. Dexmedetomidine significantly attenuated increases in HR, SBP, DBP, and MAP at all measured intervals during and after intubation compared to clonidine (p<0.05). The incidence of bradycardia and hypotension was slightly higher in the dexmedetomidine group but was manageable. Other complications, including tachycardia, hypertension, PONV, and sedation, were comparable between groups. Both clonidine and dexmedetomidine are effective in attenuating hemodynamic responses to laryngoscopy and intubation; however, dexmedetomidine provides superior control of heart rate and blood pressure fluctuations while maintaining an acceptable safety profile. Dexmedetomidine can therefore be recommended as a preferred premedication agent to enhance hemodynamic stability during elective surgical procedures.
DOI: 10.33545/26643766.2025.v8.i4b.605
Pages: 77-85 | Views: 161 | Downloads: 83
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How to cite this article:
Nishant Bhandari, Pradeep Kumar Rajbhandari. Comparative evaluation of the clonidine and dexmedetomidine on hemodynamic stability in elective surgeries. Int J Med Anesthesiology 2025;8(4):77-85. DOI: 10.33545/26643766.2025.v8.i4b.605
