Intravenous low dose clonidine premedication for attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation


  • Chandrashekarappa Kavi Associate Professor, Department of Anaesthesiology, Subbiah Institute of Medical Sciences, Purule, Shimoga
  • Ravindra CG Associate Professor, Department of Anaesthesiology, Shimoga Institute of Medical Sciences, Shimoga
  • Kiran Mallappa Assistant Professor, Department of Anaesthesiology, Shimoga Institute of Medical Sciences, Shimoga
  • Kumara AB Senior Resident, Department of Anaesthesiology, Shimoga Institute of Medical Sciences, Shimoga



Clonidine, Pressor response, Anesthetic requirement


Background: Laryngoscopy and endotracheal intubation are almost always associated with an increased sympathetic activity. To attenuate the presser response, various drugs have been tried. This study aims at finding out if the low dose of clonidine (1.5µg/kg) is best suited for this purpose.

Methods: This was a prospective study which involved two groups of patients. Each group had 30 patients who presented for elective, non-cardiovascular surgeries. The patients in group-C received Clonidine (1.5 µg/kg) and the patients in group-N received Normal saline. Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure (DBP) and Mean blood pressure (MBP) were recorded before and after intubation and at 1, 5, and 10 mins. The obtained clinical data were analyzed statistically with analysis of variance.

Results: In our study, HR, SBP, and DBP and MBP all increased during intubation and thereafter in the control groups. Pretreatment with clonidine (1.5 μg/kg) significantly attenuated the cardiovascular and catecholamine responses to tracheal intubation

Conclusion: Preoperative administration of a single dose of clonidine blunted the hemodynamic responses more than the placebo during Laryngoscopy and Intubation with reduced anesthetic requirements.



Prys-Roberts, Greene LT, Meloche R, Foex P. Studies of anaesthe¬sia in relation to hypertension-II. Haemodynamic consequences of induction and endotracheal intubation. British Journal of Anaesthe¬sia. 1971;43:541-47.

Denlinger JK, Ellison N, Ominsky AJ.Effects of intratracheallidocaine on circulatory responses to tracheal intubation. Anesthesiololgy 1974; 41: 409-12.

Stoelting RK. Attenuation of blood pressure response to laryngoscopy and tracheal intubation with sodium nitroptusside. Anesth Analg 1979; 58: 116-9.

Safwat AM, Reitan JA, Misle GR, Hurley EJ. Use of propanolol to control rate-pressure product during cardiac anaesthesia. Anesth Analg 1981;60:732-5.

Martin DE, Rosenberg H, Aukburg SJ et al. Low-dose fentanyl blunts circulatory responses to tracheal intubation. Anesth Analg 1982; 61: 680-4.

Bedford RF, Marshall WK. Hemodynamic response to endotracheal intubation: four anaesthetics. Anesthesiology 1981;55:A270.

Singh S, Arora K. Effect of oral clonidine premedication on perioper¬ative haemodynamic response and post-operative analgesic require¬ment for patients undergoing laparoscopic cholecystectomy. Indian J Anaesth. 2011 Jan-Feb; 55(1): 26–30.

Chraemmer-Jørgensen B, Hertel S, Strøm J, Høilund-Carlsen PF, Bjerre-Jepsen K. Catecholamine response to laryngoscopy and intubation. The influence of three different drug combinations commonly used for induction of anaesthesia. Anaesthesia. 1992;47(9):750-6.

Burstein CL, Lopinto FJ, Newman W. Electrocardiographic studies during endotracheal intubation. I. Effects during usual routine tech-niques. Anesthesiology. 1995;11(2):224-37.

Reid LC, Brace DE. Irritation of the respiratory tract and its reflex ef¬fect upon heart. Surg Gynaec and Obst. 1940;70:157-62.

Tanaka and T. Nisikawa. Effect of clonidine premedication on the pressor response to α- adrenergic agonists. BJA 1995;75:593-597.

Textbook of pharmacology & physiology in anesthetic practice- Robert K Stoelting-4th edition: 340-45.

Sia S. I.V. Clonidine prevents post-extradural shivering. British Journal of Anaesthesia, 1998; 81:145-146.

Nameirakpam Charan, Bijaya Hijam, Sanjot Ninave, S. Thoibahenba Singh, Upendra Keisham, Ibemhal Heisnam. A Double Blind Comparative Study of I.V. Clonidine and Fentanyl to see the Haemodynamic Response during Laryngoscopy and Intubation. Journal of Evolution of Medical and Dental Sciences 2014;3:10015-25.

Anish Sharma N.G. and Shankaranarayana P P, Pre-medication with I.V. dexmedetomidine Vs I.V. clonidine in attenuating the pressor response during laryngoscopy & endotracheal intubation, International Journal of Biomedical Research (2014) 05 (07).

Mondal S, et al. Comparison of dexmedetomidine and clonidine for attenuation of sympathoadrenal responses and anesthetic requirements to laryngoscopy and endotracheal intubation. Int J Basic Clin Pharmacol 2014;3(3):501-6.

Arora S, Kulkarni A, Bhargava AK. Attenuation of hemodynamic response to laryngoscopy and orotracheal intubation using intravenous clonidine. J Anaesthesiol Clin Pharmacol 2015;31:110-4.

R Anand Subramaniam, Shalini G Anand, Study of intravenous clonidine Vs intravenous dexmedetomidine to attenuate the response to laryngoscopy and intubation International Journal of Recent Trends in Science and Technology, March 2015; 14(2): 271-278.

Sunita Goel, Manju Sinha. Effect of oral clonidine premedication in patients undergoing laparoscopic surgery. Bombay Hospital Journal, 2006; 48(04): 587-591.

Javeherfroosh F, M Raza Pipelzadeh, Namazi M. Clonidine reduces postoperative nausea and vomiting in laparoscopic surgery. Pakistan J Med Sci, 2009;25(5):782-5.

Brest AN. Hemodynamic and cardiac effects of clonidine. J Cardiovasc Pharmacol 1980;2:S39-46.




How to Cite

Kavi, C., CG, R., Mallappa, K., & AB, K. (2017). Intravenous low dose clonidine premedication for attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation. International Journal of Research in Medical Sciences, 3(6), 1457–1461.



Original Research Articles