EFFICACY OF NALBUPHINE IN PREVENTING HAEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND INTUBATION

Objective: To determine the efficacy of nalbuphine in preventing increase in heart rate and mean arterial pressure in response to laryngoscopy and tracheal intubation. Methodology: This double blind randomized controlled trial was conducted on 100 ASA (American Society of Anesthesiologists) grade I–II patients scheduled for general anaesthesia. Patients were randomly allocated to receive either saline (group I, control group, n=50) or nalbuphine 0.2 mg kg-1 (group II, study group, n=50) as a bolus dose 5 minutes before laryngoscopy. Anaesthesia was then induced with propofol (2mg kg-1) and atracurium (0.6mg kg- 1) and orotracheal intubation was then performed within 30 seconds. Heart rate(HR) and mean arterial pressures(MAP) were recorded before the administration of the study drug, baseline value(T-0), 3 minutes after study drug administration(T-1), immediately after tracheal intubation(T-2) and then after every 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 compared to control group after laryngoscopy and orotracheal intubation that continued till 10 minutes after intubation (p-value from ˂0.0001-0.0297). The Nalbuphine group also showed significantly lesser rise in MAP compared to control group after laryngoscopy and orotracheal intubation that continued till 5 minutes after intubation (p-value from ˂0.0001-0.0152). At 10 minutes post intubation though the rise in MAP was still lesser in Nalbuphine group than 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 and mean arterial pressure associated with laryngoscopy and orotracheal intubation.