Effect of Premedication on Attenuation of Hemodynamic Response to Direct Laryngoscopy and Tracheal Intubation

Phase 4

Not yet recruiting

Conditions: Calculus of gallbladder and bile duct without cholecystitis, (2) ICD-10 Condition: C509||Malignant neoplasm of breast of unspecified site, (3) ICD-10 Condition: C269||Malignant neoplasm of ill-definedsites within the digestive system,

Brief Summary: Laryngoscopy and endotracheal intubation are essential procedures required in elective case as well as emergency resuscitative settings. It is required to secure patients airway as well as to provide oxygenation and ventilation. Despite being a critical part of anaesthesia, it is still not free from hazard. These two are considered as noxious stimuli. Laryngoscopy alone generates same pressor response as can be seen by laryngoscopy followed by intubation. Hemodynamic stress response from airway instrumentation are due to sympathetic adrenergic response caused by epi pharyngeal and para pharyngeal stimulation leading to significant rise in the catecholamine level. This leads to various responses in various physiological systems of the body such as tachycardia, hypertension, arrhythmia, bronchospasm, increased intracranial pressure, elevation in intraocular pressure, etc. These hemodynamic changes usually peak at 1 to 2 min following laryngoscopy and tracheal intubation, and persist for 5–10 mins. Various methods to attenuate sympathetic response to laryngoscopy and tracheal intubation are being used and research for better drug is going on. All the above mentioned drugs have shown beneficial effects of blunting hemodynamic responses to laryngoscopy and tracheal intubation.

Recruitment & Eligibility

Inclusion Criteria

Elective surgery under general endotracheal anesthesia.

Exclusion Criteria

Anticipated difficult intubation.
Modified Mallampati grade III/IV.
Patient’s refusal to participate in the study.
Patient receiving treatment with either of the study drug i.e., Melatonin or Clonidine; or having any known allergy to these drugs.
Patients receiving treatment for any cardiac illness, pregnancy, renal disease, liver disease, morbid obesity, bleeding disorder, thyroid disorder, etc.
Patients on anti-hypertensives, oral hypoglycemic, anti-depressants, anti-convulsant, anti-psychotics, thyroid medications, and birth control pills.
Pregnant and lactating females.
Patients with prolonged laryngoscopy time (more than 30 s).

Primary Outcome Measures

Name	Time	Method
To Compare Effect of Oral Melatonin, Oral Clonidine and Oral Pregabalin Premedication on Attenuation of Hemodynamic Response to Direct Laryngoscopy and Tracheal Intubation.	At baseline
Hemodynamic changes like HR, SBP, DBP and MBP	At baseline

Secondary Outcome Measures

Name	Time	Method
Requirement of intraoperative rescue Propofol doses and need for antihypertensive drug.

Locations (1): Sardar Patel Medical College Bikaner
🇮🇳
Bikaner, RAJASTHAN, India
Sardar Patel Medical College Bikaner
🇮🇳Bikaner, RAJASTHAN, India
Dr Anurag
Principal investigator
9460569487
anumbbs13@gmail.com