Comparison of fentanyl, clonidine and nalbuphine for attenuation of pressor response during endotracheal intubation under general anaesthesia

Abstract

Background: Increased sympathoadrenal activity invariably occurs during endotracheal intubation. Various drugs have been used to obtund this pressor response. This study was done to find out most favourable drug among fentanyl, nalbuphine and clonidine for prevention of this pressor response. Materials and Methods: This was a randomized, prospective study involving ninety patients of ASA grade 1, equally divided into three groups. Group F, C and N received fentanyl 2 mcg /kg, Clonidine 2 mcg/kg and nalbuphine 2mg/kg i.v respectively, 5 minutes prior to induction. Vitals parameters were noted at frequent intervals Chi square test and Anova test were used for statistical analysis. P value <0.05 was considered as statistically significant. Results: Maximum increase in heart rate and blood pressure was seen at the time of intubation in F and N groups, whereas decrease in these parameters occured with clonIdine, difference was found to be stastistically significant. Haemodynamic stability was seen in F and N group after 5 minutes of intubation. Clonidine showed maximum decrease in heart rate and systolic as well as diastolic blood pressure at all time intervals from intubation as compared to other two groups. Conclusion: In this study it was found that Clonidine produced an earlier and more stable haemodynamics as compared to Fentanyl and Nalbuphine, and it can be concluded that Clonidine given intravenously in doses of 2 mcg/kg 5 minutes prior to intubation is superior to Fentanyl and Nalbuphine in preventing heamodynamic changes at the time of laryngoscopy and intubation.

Hypotension Is Associated With Perioperative Myocardial Infarction: Individualized Blood Pressure Is Important

“…Indeed, in 2020, a study reported on a variety of agents being used to blunt the hypertensive response to laryngoscopy, highlighting a continued focus on the risks associated with hypertension. 5 However, for more than a decade, perioperative hypotension has been shown to be detrimental. In the Perioperative Ischemic Evaluation (POISE) study, 6 perioperative hypotension was the major population-based risk factor for all-cause mortality.…”