Oral Clonidine versus Oral Midazolam as a Preoperative Medication in Hypertensive Patients

Abstract

The demand of patients is to face the operation with calm, confidence and without anxiety. In modern anesthesia practice, for general anesthesia (GA), Laryngoscopy and endotracheal intubation are done frequently which is invariably associated with rise in heart rate (HR), arterial blood pressure (BP), and occasional disturbance of cardiac rhythm. These hemodynamic responses arise as a form of sympathoadrenal reflex. This adrenergic stress response is extremely harmful in patients with cardiac disorders, old age, hypertensive patients, and neurological disturbances (Das et al., 2013). A number of drugs have been used for attenuation of the cardio-vascular response. The list includes topical lignocaine, intravenous (IV) lignocaine, IV Hydralazine, volatile anesthetic agents, narcotic analgesics, adrenergic blockers, and vasodilators like nitroglycerine and nifedipine, etc. Midazolam, a benzodiazepine, is the most commonly used premedication because of its anxiolytic and hypnotic effect, a short elimination half-life and high clearance, better anterograde amnesia, and minor effect on hemodynamic and respiratory inhibition compared to other benzodiazepines (Almenrader et al., 2007).