Comparison of intravenous nalbuphine and fentanyl on attenuation of pressor response during laryngoscopy and endotracheal intubation

Indira; Mamta Khandelwal; Usha Bafna; Fareed Ahmed

Volume : VI, Issue : IX, September - 2017

Comparison of intravenous nalbuphine and fentanyl on attenuation of pressor response during laryngoscopy and endotracheal intubation

Indira, Mamta Khandelwal, Usha Bafna, Fareed Ahmed

Abstract :

Background and Aim– Sympathetic response evoked by laryngoscopy and endotracheal intubation is ephemeral but results in marked increase in blood pressure and heart rate. Various drugs and methods have been tried to obtund this response. To obtain ideal drugs, studies still continue. We compared the efficacy of nalbuphine and fentanyl to attenuate the pressor response during laryngoscopy and intubation.

Method– Total 90 patients of ASA grade I & II scheduled for elective surgery under general anaesthesia, were randomized into two groups. Group A received nalbuphine 0.2 mg /kg IV and group B received fentanyl 2 �g/kg IV 5 minutes before intubation. Heart rate and blood pressure (SBP, DBP &MAP) were recorded before administration of study drug, just before intubation and then 1,3,5,10,15 minutes after intubation.

Statistical analysis– All the qualitative data were analysed with chi square test and all the quantitative data were analysed with unpaired student t–test.

Results– Rise of mean HR immediately after intubation was less in group B as compared to group A (P<0.05) .Heart rate changed from 92.24�10.78 to 99.51�10.63 bpm (+2.25%) in group B and in group A it was 96.022�13.81 to 106.42�11.44bpm (+8.07%). One minute post intubation rise of blood pressure (SBP, DBP and MAP) was also less in group B as compared to group A (P <0.05).

Conclusion–Fentanyl appears to be better than Nalbuphine for control of haemodynamic response to laryngoscopy and intubation.