Comparative Study of Fentanyl, Butorphanol and Nalbuphine in Attenuation of Haemodynamic Responses in Laparoscopic Cholecystectomy

Rekhi, Balwinder Kaur; Grewal, Tejinderpal Kaur; Kumar, Parmod; Kaur, Simrit; Mehta, Priyanka

doi:10.14260/jemds/2018/483

Cited by 3 publications

(5 citation statements)

References 10 publications

(3 reference statements)

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“…[14][15][16] In study by Rekhi et al they found nalbuphine (0.2mg/kg) effective in obtunding hemodynamic response to pneumoperitoneum, whereas Vidhya et al found the same dose less effective. 18,19 In our study, we found that heart rate did not increase at the time of creation of pneumoperitoneum or at any subsequent time points in both the groups. This may be attributed to the use of a balanced technique of anaesthesia for all the patients.…”

Section: Discussionsupporting

confidence: 41%

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Efficacy of nalbuphine for suppression of hemodynamic responses to pneumoperitoneum- A prospective randomised controlled study

Salhotra¹,

Singhal

Rautela³

et al. 2023

IJCA

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Pneumoperitoneum created during laparoscopic surgeries induces significant hemodynamic changes. This study was aimed to explore the efficacy of nalbuphine to suppress hemodynamic responses to pneumoperitoneum.This was a prospective randomised controlled study conducted on 80 ASA I/II patients between 18-60 yr after institutional ethics committee approval and written informed consent. Presence of pregnancy, multiple drug therapy, cardiovascular, renal or hepatic diseases were taken as exclusion criteria. Based on a computer generated random number table patients were allocated to one of the two groups; Group N: Nalbuphine 0.3 mg/kg and Group S: Normal saline. Hemodynamic parameters, time to request of rescue analgesic, sedation and side effects were recorded. Data was analysed using student t-test and Chi square/Fisher’s exact test, repeated measure ANOVA. A p-value<0.05 was taken as significant. Group N patients had lower heart rate after test drug and for the first 30 min and on deflation of pneumoperitoneum. The mean and systolic blood pressure decreased at the time of creation of pneumoperitoneum (p<0.001). VAS score was significantly lower in the first 30 min postoperatively in group N (p=0.004). Number of patients who requested for rescue analgesic within 2 h postoperatively, incidence of PONV and shivering were comparable. Sedation was higher in immediate postoperative period in group N (p=0.002). Nalbuphine provides stable hemodynamics for first 30 min after creation of pneumoperitoneum for laparoscopic procedures. It also provides postoperative analgesia for a short duration of 30 min.

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Section: Discussionsupporting

confidence: 41%

“…However, the results were found to be contradictory. 18,19 This study was planned to find out the haemodynamic effects of 0.3 mg/kg nalbuphine administered before creation of pneumoperitoneum in patients undergoing laparoscopic surgeries.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of nalbuphine for suppression of hemodynamic responses to pneumoperitoneum- A prospective randomised controlled study

Salhotra¹,

Singhal

Rautela³

et al. 2023

IJCA

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“…In a study done by Balwinder Kaur Rekhi et al, it was found that intravenous dexmedetomidine prolonged the effect of ropivacaine (3 mg). [ 18 ]…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled study using ropivacaine with intravenous adjuvants in spinal anaesthesia in lower limb surgeries

Malik

Nagraj

2020

Anesth Essays Res

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Background: In recent years, several adjuvants have been used to prolong the duration of the subarachnoid block. These adjuvants have either been used via intrathecal route or intravenous (i.v.) route. Dexmedetomidine and clonidine have been used as adjuvants to local anesthetic drugs by intrathecal, epidural, caudal, and i.v. routes and for peripheral nerve blocks. In this study, we endeavored at finding the efficacy of dexmedetomidine and clonidine in improving the analgesia quality and duration of the subarachnoid block. Setting and Design: A prospective, double-blind, randomized control trial comprising 70 subjects posted for elective lower limb surgeries. Materials and Methods: Seventy patients were selected at random and were allocated to two groups (Group C and Group D) of 35 each. In Group C, the patients received isobaric ropivacaine with clonidine 1.0 μg.kg −1 intravenously. In Group D, the patients received isobaric ropivacaine with dexmedetomidine 0.5 μg.kg −1 intravenously. Perioperatively, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and oxygen saturation were recorded and documented every 5 min till the end of surgery. Time of onset, level of sensory blockade, and duration of sensory blockade were recorded. Motor block was assessed using modified Bromage scale. Data validation and analysis were carried out by SPSS version 16. A P < 0.05 was considered statistically significant. Results: Time of onset of sensory block in Dexmedetomidine group and Clonidine group was 2.70 ± 1.25 minutes and 3.50 ± 1.23 minutes respectively ( P = 0.021). Time of onset of motor block in Dexmedetomidine group and Clonidine group was 3.55 ± 1.60 minutes and 4.30 ± 1.45 minutes respectively ( P = 0.034). Time for 2 segment regressions of sensory block in Dexmedetomidine group and Clonidine group was 140.30 ± 12.32 minutes and 125.65±14.33minutes respectively ( P = 0.047). Time of regressions of motor blockade to Bromage Scale 1 in Dexmedetomidine group and Clonidine group was 148.65 ± 15.23 minutes and 129.70 ± 19.35 minutes respectively ( P = 0.032). Conclusion: The use of i.v. dexmedetomidine perioperatively prolongs the duration of sensory and motor block significantly when compared to i.v. clonidine.

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“…Catecholamines evoke changes in carbohydrate metabolism reflected as an increase in blood sugar levels. 2,10,13 Various drugs have been used to attenuate the stress response in laparoscopic cholecystectomy. Earlier studies have been done with Dexmedetomidine on blood sugar levels compared with fentanyl.…”

Section: Discussionmentioning

confidence: 99%

“…The hemodynamic changes are characterized by increased systemic and pulmonary vascular resistance, a rise in arterial pressure and heart rate with reduced cardiac output. 1,2 Though better tolerated in ASA I and II patients, these changes can be detrimental in elderly and ASA III patients with compromised cardiovascular physiology. 3,4 Various surgical methods and pharmacological agents were used to decrease the surgical stress of laparoscopic procedures to improve outcome.…”

Section: Introductionmentioning

confidence: 99%

Estimation of Blood Glucose Levels And Hemodynamic Changes During Laparoscopic Cholecystectomy: A Comparison of Dexmedetomidine and Nalbuphine

Fayaz

Asad²,

Khurshid

et al. 2022

PAFMJ

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Objective: To compare the effect of Dexmedetomidine and Nalbuphine premedication on changes in hemodynamics and neuroendocrine stress response under general anaesthesia by analyzing the variation of perioperative serial blood glucose levels. Study Design: Prospective comparative study. Place and Duration of Study: Services Hospital, Lahore Pakistan, from Oct to Dec 2020. Methodology: Total 90 patients aged between 30-and 65 years were allocated randomly into three groups. Group-D patients (n=30) were administered Dexmedetomidine 0.5 μg/kg in 100 ml normal saline, group-N (n=30) were given Nalbuphine 0.1 mg/kg in 100ml saline, and group-S received saline (100ml) throughout 15 minutes before induction of anaesthesia for laparoscopic cholecystectomy. General Anaesthesia was administered. Intra-abdominal pressure was maintained after abdominal insufflation with carbon dioxide between 12-15 mmHg. Blood glucose levels were analyzed preoperatively, 30 minutes after the beginning of surgery, at extubation and 2.5 hours postoperatively. Hemodynamic changes were recorded after premedication, 15 and 30 minutes after pneumoperitoneum and extubation. Results: Random mean blood sugar levels were 135.23 mg/dl with Dexmedetomidine and 123.33 mg/dl with Nalbuphine and 122.53 mg/dl in saline group (p<0.05). There was a greater decrease in hemodynamic parameters with group-D than with groups N and S (p<0.01). Conclusion: During laparoscopic cholecystectomy, intravenous Dexmedetomidine premedication attenuates the hemodynamic stress response better than Nalbuphine but does not suppress the neuroendocrine response as estimated by a rise in random blood glucose level.

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Comparative Study of Fentanyl, Butorphanol and Nalbuphine in Attenuation of Haemodynamic Responses in Laparoscopic Cholecystectomy

Cited by 3 publications

References 10 publications

Efficacy of nalbuphine for suppression of hemodynamic responses to pneumoperitoneum- A prospective randomised controlled study

Efficacy of nalbuphine for suppression of hemodynamic responses to pneumoperitoneum- A prospective randomised controlled study

Randomized controlled study using ropivacaine with intravenous adjuvants in spinal anaesthesia in lower limb surgeries

Estimation of Blood Glucose Levels And Hemodynamic Changes During Laparoscopic Cholecystectomy: A Comparison of Dexmedetomidine and Nalbuphine

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