Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;67(7):633-637.
doi: 10.4103/ija.ija_731_22. Epub 2023 Jul 14.

Assessment of haemodynamic response to tracheal intubation and prone positioning following clonidine and enalaprilat in lumbar spine surgeries: A double blind randomised controlled trial

Meshach M Dhas  1 , Balasubramaniam Gayathri  1 , Anand Kuppusamy  1 , Karthik Mani  1 , Harish Pattu  1
Affiliations

Assessment of haemodynamic response to tracheal intubation and prone positioning following clonidine and enalaprilat in lumbar spine surgeries: A double blind randomised controlled trial

Meshach M Dhas et al. Indian J Anaesth. 2023 Jul.

Abstract

Background and aim: This study evaluates the effectiveness of long-acting antihypertensive drugs (clonidine and enalaprilat) in blunting the intubation response. Also, the study seeks to determine how effectively clonidine and enalaprilat can maintain stable haemodynamics during a change in position.

Methods: After ethical committee approval and trial registration, a double-blinded, randomised controlled trial was conducted with 71 consenting patients scheduled for elective spine surgery in a prone position under general anaesthesia. Group C received clonidine 2 μg/kg, and Group E received enalaprilat 1.25 mg diluted in normal saline as an intravenous infusion given over 10 min before induction of anaesthesia. The changes in heart rate (HR) and blood pressure (BP) in response to the infusion of the study drugs, induction, tracheal intubation and change in position were recorded. P value <0.05 was considered significant. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25.

Results: Clonidine infusion caused a significant fall in heart rate post-infusion and post-induction with propofol (p value <0.05). Both clonidine and enalaprilat caused a significant fall in mean arterial pressure (MAP) post-infusion and post-induction (p value <0.05). Clonidine effectively blunted the intubation response with no increase in HR and MAP following intubation. Enalaprilat caused a significant rise in HR in response to intubation. On proning, there was a significant fall in MAP in both groups.

Conclusion: Clonidine is effective in blunting the intubation response. Preoperative infusion of clonidine and enalaprilat causes hypotension during a change of position.

Keywords: Clonidine; enalaprilat; haemodynamics; intubation; prone position; spine surgery.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow of participants in the study
Figure 2
Figure 2
Heart rate variation between group C and group E. HR-Heart rate
Figure 3
Figure 3
Mean arterial pressure variation between group C and group E. MAP-Mean arterial pressure
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Pavithran P, Renuka S, Pramod SK, Salin E, Biju S, Kishore K. Comparison of the thoracolumbar interfascial plane block with local anaesthetic infiltration in lumbar spine surgeries –A prospective double-blinded randomised controlled trial. Indian J Anaesth. 2022;66:436–41. - PMC - PubMed
    1. Rastogi B, Gupta K, Gupta PK, Agarwal S, Jain M, Chauhan H. Oral pregabalin premedication for attenuation of the haemodynamic pressor response of airway instrumentation during general anaesthesia: A dose-response study. Indian J Anesth. 2012;56:49–54. - PMC - PubMed
    1. Savitha KS, Dhanpal R, Vikram MS. Haemodynamic responses at intubation, change of position, and skin incision: A comparison of multimodal analgesia with the conventional analgesic regime. Anesth Essays Res. 2017;11:314–20. - PMC - PubMed
    1. Bafna U, Sharma P, Singhal RK, Gurjar SS, Bhargava SK. Comparison of hypotensive properties of dexmedetomidine versus clonidine for induced hypotension during functional endoscopic sinus surgery: A randomised, double-blind interventional study. Indian J Anaesth. 2021;65:579–85. - PMC - PubMed
    1. Rajaprabu T, Kumar V. Comparison between the haemodynamic stability of dexmedetomidine and clonidine infusions among patients undergoing laparoscopic cholecystectomy- A randomised controlled trial. Indian J Clin Anaesth. 2019;6:437–40.

LinkOut - more resources