Oral premedication with pregabalin or clonidine for attenuating the pressor response to laryngoscopy and tracheal intubation in laparoscopic cholecystectomy

Background and Aims: The aim of the study was to compare the hemodynamic response to laryngoscopy and intubation after pregabalin and clonidine premedication and the effect of pneumoperitoneum on hemodynamic parameters in laparoscopic cholecystectomy. Materials and Methods: One hundred and twenty patients aged 18–60 years scheduled for laparoscopic cholecystectomy were randomly divided into three groups of 40 each. Group I received vitamin tablet, Group II received pregabalin 150 mg, and Group III received clonidine 200 μg as oral premedication 60 min before induction. The heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure were monitored at predefined intervals, i.e., before giving test drug (T1), 30 min after the drug (T2), before induction (T3), immediately after induction (T4), immediately after intubation (T5), 1, 3, 5, and 10 min after intubation (T6, T7, T8, and T9), before creating pneumoperitoneum (T10), 15 min after creating pneumoperitoneum (T11), and 10 min after release of pneumoperitoneum (T12). Results: HR was comparable in the three groups preoperatively. Compared to Group I in Group II, HR was lower at T5 and also at T6, T7, T8, T9, T10, T11, and T12 intervals (P < 0.001). In Group III, HR was statistically lower at all the intervals after 30 min of giving the test drug (P < 0.05) compared to Group I. Compared to Group II in Group III, there was a significant fall in HR at T2, T4, T6, T8, T9, T10, T11, and T12 intervals (P < 0.05). SBP was comparable in all the three groups at baseline. Compared to the Group I in Group II, it was significantly lower at T3, T4, T5, T6, T7, T8, and T11 intervals (P < 0.05). Compared to Group I in Group III, SBP was significantly lower at T2, T5, T6, T7, T8, T9, T10, and T11 intervals (P < 0.05). In Group III, there was a significant fall of SBP at T6, T7, T8, T9, T10, and T11 intervals (P < 0.05) in comparison to Group II. Conclusion: Pregabalin 150 mg as premedicant obtunds the pressor response to laryngoscopy, intubation, and pneumoperitoneum with minimal side effects in laparoscopic cholecystectomy compared to clonidine