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A Comparative Study of the Effects of Premedication with Oral Clonidine versus Oral Pregabalin in Patients Undergoing Lumbar Spine Surgery

Rathna Paramaswamy, Professor, Department of Anaesthesia, Saveetha Medical College Hospital, Saveetha University, Chennai, Tamil Nadu 602105, India. , K. Gunasekaran1 , Rathna Paramaswamy2

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Indian Journal of Anesthesia and Analgesia 5(1):p 68-76, January-February 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.10

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Aim: The aim of this study was primarily to compare the efficacy of single pre operative dose of oral pregabalin versus oral clonidine in attenuation of pressor response to direct laryngoscopy and intubation and on the intra operative haemodynamic stability in patients undergoing elective lumbar spine surgery. The secondary outcome was to evaluate the intra operative opioid consumption in both the drug groups. Background: Direct laryngoscopy and intubation are painful stimuli which cause reflex sympathetic nervous system stimulation resulting in untoward haemodynamic response. This study compares the effect of single oral pre-operative dose of clonidine versus oral pregabalin in attenuation of the pressor response to direct laryngoscopy and intubation and the intra-operative haemodynamics in patients undergoing lumbar spine surgery. Materials & Methods: This randomized double blinded trial was conducted in our tertiary care hospital. After obtaining informed written consent, sixty adult patients belonging to ASA I and ASA II undergoing elective lumbar spine surgery under general anaesthesia were randomly divided into two groups of thirty each. Group C received 100 g of oral clonidine and Group P received 150 mg of oral pregabalin ninety minutes prior to induction of anaesthesia. Systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR) were measured at three time points; baseline ( 3 min before induction),just before laryngoscopy, 1, 3, 5, 10 and 15 min after intubation.The intra operative haemodynamics and fentanyl consumption was recorded for all patients. Statistical analysis was done using students’t test and chi square test. Results: Both drugs attenuated the haemodynamic pressor response associated with laryngoscopy and endotracheal intubation. The reduction in SBP, DBP, and MAP was comparable in both groups but the tachycardia was attenuated significantly in the clonidine group (P value< 0.05). The intra operative fentanyl consumption was lesser in the clonidine group than the pregabalin group (P value=0.0069). Conclusions: Oral pregabalin and clonidine successfully attenuated the pressor response to direct laryngoscopy and intubation. No adverse effects were observed with the doses used in our study. The intraoperative analgesic consumption was less in both the groups.

 

Keywords: Clonidine; Lumbar Spine Surgery; Pregabalin; Premedication; Pressor Response. 

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DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.10

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