Efficacy of nalbuphine in preventing haemodynamic response to laryngoscopy and intubation

Abstract

Objective: To determine the efficacy of nalbuphine in preventing increase inheart rate and mean arterial pressure in response to laryngoscopy and trachealintubation.Methodology: This double blind randomized controlled trial was conductedon 100 ASA (American Society of Anesthesiologists) grade I–II patients scheduledfor general anaesthesia. Patients were randomly allocated to receive eithersaline (group I, control group, n=50) or nalbuphine 0.2 mg kg-1 (groupII, study group, n=50) as a bolus dose 5 minutes before laryngoscopy. Anaesthesiawas then induced with propofol (2mg kg-1) and atracurium (0.6mg kg-1) and orotracheal intubation was then performed within 30 seconds. Heartrate(HR) and mean arterial pressures(MAP) were recorded before the administrationof the study drug, baseline value(T-0), 3 minutes after study drugadministration(T-1), immediately after tracheal intubation(T-2) and then afterevery 1 minute upto 5 minutes (T3-7) and then after 10 minutes of intubation(T-8).Results: The Nalbuphine group showed significantly lesser rise in HR comparedto control group after laryngoscopy and orotracheal intubation thatcontinued till 10 minutes after intubation (p-value from Ë‚0.0001-0.0297). TheNalbuphine group also showed significantly lesser rise in MAP compared tocontrol group after laryngoscopy and orotracheal intubation that continuedtill 5 minutes after intubation (p-value from Ë‚0.0001-0.0152). At 10 minutespost intubation though the rise in MAP was still lesser in Nalbuphine groupthan control group but it was not significant (p-value=0.0540).Conclusion: Nalbuphine 0.2 mg kg-1 prevents a marked rise in heart rate andmean arterial pressure associated with laryngoscopy and orotracheal intubation.