A comparative study of intranasal dexmedetomidine and clonidine using a mucosal atomisation device on hemodynamic response t laryngoscopy during intubation

This prospective, randomized, double-blind, two-arm parallel clinical trial aims to compare the efficacy and safety of intranasal dexmedetomidine and intranasal clonidine, administered via mucosal atomization device, in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation in adult patients undergoing elective surgery under general anaesthesia. A total of 76 ASA I–II patients aged 18–60 years will be randomly allocated into two groups to receive either intranasal clonidine (3 mcg/kg) or intranasal dexmedetomidine (1 mcg/kg) 45 minutes prior to induction of anaesthesia. Hemodynamic parameters including heart rate and mean arterial pressure will be recorded at predefined intervals before and after intubation. Sedation will be assessed using Ramsay Sedation Score. The primary outcome is the change in mean arterial pressure at 1 minute after intubation compared to baseline. Secondary outcomes include heart rate changes, sedation profile, and incidence of adverse events. The study aims to determine the superior intranasal alpha-2 agonist for blunting the pressor response while maintaining hemodynamic stability and safety.