A Comparative Study of Dexmedetomidine and Nalbuphine for the Attenuation of Hemodynamic Response to Laryngoscopy and Intubation in a Tertiary Care Hospital, Telangana

Mohd Moazzam Mohiuddin Ansari, Mohammed Abdul Samad, P. Sravani, Bharathi Rajan
Author(s)
1Assistant Professor, Department of Anesthesia, Sarojini Devi Eye Hospital, Osmania Medical College, Hyderabad, Telangana, India. 2Assistant Professor, Department of Anesthesia, Gandhi Medical College and Hospital, Secunderabad, Telangana, India. 3Assistant Professor, Department of Anesthesia, Government General and Chest Hospital, Osmania Medical College, Hyderabad, Telangana, India. 4Senior resident, Department of Anesthesia, Osmania Medical College and Hospital, Hyderabad, Telangana, India.

Abstract

Background: Laryngoscopy and endotracheal intubation are associated with increased sympathetic response, resulting in a transient tachycardia and hypertension. Such alterations are potentially detrimental, especially among cardiovascular comorbid patients. This response can be attenuated with pharmacological agents such as dexmedetomidine and nalbuphine. The current study aimed to determine the efficacy of dexmedetomidine and nalbuphine in reducing hemodynamic response to laryngoscopy and endotracheal intubation. Material and Methods: This was a prospective comparative study involving 100 patients who underwent elective surgeries under general anesthesia. There were two groups of patients (n=50) each; Group D received Dexmedetomidine 1 µg/kg, and Group N received Nalbuphine 0.2 mg/kg before induction. Hemodynamic measurements such as heart rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), and oxygen saturation (SpO2) were measured at baseline and 1, 3, 5, and 10 minutes after intubation. Chi-square test was conducted to statistically analyze the data, and p < 0.05 was considered significant. Results: Baseline parameters were similar in the groups. Overall, Group D exhibited much lower HR, SBP, DBP, and MAP at all post-intubation time points than Group N (p < 0.001). SpO2 was maintained at a steady and similar level in the two groups across the period of study, and there were no significant clinical differences. Dexmedetomidine was better at attenuating the hemodynamic response to laryngoscopy and intubation. Conclusion: Compared to nalbuphine, dexmedetomidine is more effective in reducing the cardiovascular response to laryngoscopy and endotracheal intubation and achieves a better cardiovascular stability without the need to affect oxygenation.

Keywords: Dexmedetomidine, Nalbuphine, Laryngoscopy, Intubation, Hemodynamic response, General anesthesia.

Outline