BACKGROUND AND OBJECTIVE: This study compares the effect of oral clonidine vs. hydroxyzine on the haemodynamic and catecholamine responses to microlaryngoscopy. METHODS: Thirty-five ASA II-III patients were included in this double-blind randomized trial. The patients received either hydroxyzine 1 mg kg-1 (n = 18) or clonidine 3 micrograms kg-1 (n = 17) for their oral premedication 100 min before an intravenous induction of anaesthesia using propofol (2-3 mg kg-1) and fentanyl (2 micrograms kg-1). Arterial pressure and heart rate were measured before premedication, and throughout the procedure and recovery. Plasma catecholamine levels were determined before premedication, after induction, and 1.5, 30 and 120 min after laryngoscopy. RESULTS: Mean arterial pressure was significantly lower after clonidine, whereas there was no difference in heart rate and plasma catecholamine levels between the two groups. CONCLUSIONS: Clonidine for premedication significantly decreased mean arterial pressure during microlaryngoscopy and the following recovery phase but did not modify the overall haemodynamic response to the suspension microlaryngoscopic nociceptive stimulus.