Comparative Effects of Oral Clonidine versus Oral Pregabalin Premedication on Hemodynamic Response to Laryngoscopy and Intubation: A Randomized Double-Blind Study

Abstract

Background: Laryngoscopy and endotracheal intubation often trigger significant hemodynamic responses that may be detrimental in high-risk patients. This study compared the efficacy of oral clonidine versus pregabalin in attenuating these responses. Methods: This prospective, double-blind, randomized study included 75 ASA I patients undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated to receive either oral clonidine 5μg/kg (n=25), pregabalin 150mg (n=25), or placebo (n=25) 60 minutes before surgery. Hemodynamic parameters were recorded at baseline and at specified intervals during the perioperative period. Results: The clonidine group demonstrated superior control of heart rate (75.44±4.38 vs 82.28±3.04 vs 91.20±8.86 beats/min, p<0.001) and systolic blood pressure (115.96±2.54 vs 121.56±3.13 vs 130.12±8.26 mmHg, p<0.001) at 3 minutes post-intubation compared to pregabalin and placebo groups respectively. Mean arterial pressure was also better controlled in the clonidine group (85.52±2.90 vs 92.76±3.12 vs 96.72±5.30 mmHg, p<0.001). This superior hemodynamic control persisted throughout the surgical period. Conclusion: Oral clonidine 5μg/kg provides more effective attenuation of the hemodynamic response to laryngoscopy and intubation compared to pregabalin 150mg or placebo in ASA I patients undergoing laparoscopic cholecystectomy.