Role of IV Nalbuphine in attenuation of haemodynamic response to laryngoscopy and endotracheal intubation

Fating, Dnyaneshwar Ramaji; Dandekar, Ashwini K.; Tirpude, Naresh G.

doi:10.5958/2394-4994.2016.00033.0

Cited by 3 publications

(2 citation statements)

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“…It does not allow increase in systemic blood pressure, pulmonary blood pressure, heart rate, thus may be useful for providing sedation and analgesia for cardiac patients. [8,9] The selection of dosages for the present study was based on the assumption that which almost equipotent doses could supress the hemodynamic changes with minimal side effects.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Hemodynamic Changes during Direct Laryngoscopy and Intubation by Intravenous Clonidine or Nalbuphine Premedication - A Comparative Evaluation

Bansal

Gupta

Kumar

et al. 2019

AAN

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Background: Accentuated hemodynamic changes during direct laryngoscopy can be modified by appropriate premedication. The present study was aimed to comparatively evaluate the clinical efficacy of intravenous clonidine with nalbuphine premedication for reduction in hemodynamic changes during direct laryngoscopy and intubation. Subjects and Methods: Sixty adult consenting patients of ASA physical status I and II of either gender, were randomized into two equal groups of 30 patients each to receive either clonidine (2 µg/kg) Group I or nalbuphine (0.2 mg/kg) Group II, intravenously 10 minutes before induction. Anesthetic technique was standardised and direct laryngoscopy with intubation was facilitated with vecuronium bromide. Changes in heart rate, arterial blood pressure and ECG were recorded at baseline, after giving study drug, after laryngoscopy and intubation, then after at 1st, 2nd, 3rd, 5th, 10th, and 15th min of intubation and were noted as primary end points. Any side effects and complications were recorded as secondary end points. Results: After premedication in patients of comparable demographic profile, the fall in heart rate and blood pressure showed statistically significant difference between the groups. After laryngoscopy and intubation, the increase in mean heart rate and mean blood pressure occurred immediately in patients of both groups but persisted up to 5 to 7 min in patients of clonidine group and up to 10 minutes in patients of nalbuphine group with statistically significant difference between the groups. Conclusion: Intravenous clonidine premedication (2 µg/kg) could effectively reduce the hemodynamic changes during direct laryngoscopy and intubation when compared to intravenous nalbuphine (0.2 mg/kg), administered 10 min before induction.

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Section: Discussionmentioning

confidence: 99%

Reduction in Hemodynamic Changes during Direct Laryngoscopy and Intubation by Intravenous Clonidine or Nalbuphine Premedication - A Comparative Evaluation

Bansal

Gupta

Kumar

et al. 2019

AAN

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“…Nalbuphine is a type of agonist-antagonist morphine drug with analgesic and sedative effects which was first used clinically in the 1970s ( 12 ). This study found no significant differences in terms of operation time and intraoperative blood loss between the observation and control groups.…”

Section: Discussionmentioning

confidence: 99%

Nalbuphine analgesic and anti-inflammatory effects on patients undergoing thoracoscopic lobectomy during the perioperative period

Zhang

Jiang

2017

Experimental and Therapeutic Medicine

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This study sought to investigate the analgesic effects of nalbuphine on patients undergoing thoracoscopic lobectomy during the perioperative period, as well as its effects on inflammatory cytokines. We selected 92 patients with early lung cancer who were admitted to Xiangyang No. 1 People's Hospital between January 2016 and December 2016. The patients were randomly divided into control and observation groups (n=46 each). All patients underwent thoracoscopic lobectomy, with those in the observation group receiving intravenous nalbuphine hydrochloride prior to induction (the control group received saline). Intraoperative blood loss, operation time and anesthetic dosages were compared between groups. The analgesic effects during the perioperative period were compared using a visual analogue scale. The adverse effects of anesthetics (nausea, vomiting, dizziness and drowsiness) were compared between the two groups. Finally, serum inflammatory cytokine [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10] levels were measured using ELISA at 1, 3, 5 and 7 days after operation. There were no significant differences in intraoperative blood loss and operation time between the two groups (p>0.05). However, dosages of propofol and remifentanil used were lower in the observation group than in the control group (p<0.05), and the effective rate of postoperative analgesia in the observation group was significantly higher than that in the control group (p<0.05). The degree of postoperative pain in both groups were lower than preoperative rates (p<0.05), while the incidence of adverse reactions in the observation group was significantly lower than in the control group (p<0.05). Finally, TNF-α, IL-6 and IL-10 levels were significantly lower in the observation group relative to the control group at 1, 3, 5 and 7 days after operation (p<0.05). Therefore, nalbuphine has a significant analgesic effect during thoracoscopic lobectomy. The application of nalbuphine can reduce the incidence of adverse reactions, reduce postoperative inflammatory responses, and promote rapid patient recovery, thus demonstrating the clinical value of nalbuphine.

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Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

Rathore¹,

Chaudhary²,

Kumar³

et al. 2021

IJCA

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Laryngoscopy and intubation are noxious stimuli which result in marked sympathetic response. However, literature search did not reveal any study comparing nalbuphine and dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation. After Institutional Ethical Committee approval and written informed consent, 80 ASA I and II patients were randomised in two groups of 40 each. Group N received 0.2 mg/kg of nalbuphine; group D received 1 µg/kg dexmedetomidine over a period of 10 min. Anaesthesia was induced as per standard general anaesthesia practice. Haemodynamic parameters [Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), & Mean Arterial Pressure (MAP)] were recorded at baseline, 0, 1, 3, 5, 10, and 15 min following intubation. Patients were also observed for any side effects of the study drugs.There was a significant decrease (p<0.001) in mean HR in group D compared to group N, after administration of drug and 1 min after intubation. Both group N and group D showed no significant increase in mean HR at any time point compared to baseline values. There was no significant increase in mean SBP at any time interval in both the groups when compared to baseline. There was a significant increase (p<0.001) in mean DBP and MAP at the time of intubation in group N whereas no significant increase in mean DBP, and MAP was observed in group D at any time point. Dexmedetomidine was found to be more effective in attenuating haemodynamic response to laryngoscopy and intubation as compared to nalbuphine.

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Role of IV Nalbuphine in attenuation of haemodynamic response to laryngoscopy and endotracheal intubation

Cited by 3 publications

References 0 publications

Reduction in Hemodynamic Changes during Direct Laryngoscopy and Intubation by Intravenous Clonidine or Nalbuphine Premedication - A Comparative Evaluation

Reduction in Hemodynamic Changes during Direct Laryngoscopy and Intubation by Intravenous Clonidine or Nalbuphine Premedication - A Comparative Evaluation

Nalbuphine analgesic and anti-inflammatory effects on patients undergoing thoracoscopic lobectomy during the perioperative period

Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

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