ABSTRACT
BACKGROUND: Laryngoscopy and intubation are associated with increase in heart rate and mean blood pressure which are deleterious for patients especially with hypertension, ischaemic heart disease, raised intraocular and intracranial pressure. This study was undertaken with an objective to determine the efficacy of nalbuphine in preventing increase in heart rate and mean arterial pressure in response to laryngoscopy and orotracheal intubation. PATIENTS #ENTITYSTARTX00026; METHODS: A randomized controlled, prospective, double blinded study was undertaken on 60 patients ASA grade I and II posted for elective laparoscopy surgery to receive either saline (group I, control group, n=30) or Nalbuphine 0.2mg kg(-1)(group II, study group, n=30 ) as a bolus dose, 5 minutes before laryngoscopy. Heart rate and mean arterial pressure were taken 3 minute after study drug (T-1), just after intubation (T-2), then after every minute till 5 min (T3-7) and after 10 min of intubation (T-8). Twenty percent rise in heart rate and mean arterial pressure was considered as significant. Students 't' test was used for the analysis of data by using statistical software Medcal version 11.1.1.0. and P < 0.05 was considered significant. RESULTS: There was significant rise in heart rate(20.4%) in group I after intubation at T-2 compared with baseline at T-1 as compared to group II (16.66%). Mean arterial pressure showed rise of 12.35% in group I and 4.39% in group II at T-2 but was not significant. Heart rate and mean arterial pressure then gradually decreased from T3-8 but remained slightly higher than group II at 8th minute. CONCLUSION: We thus conclude that Nalbuphine 0.2 mg kg (-1)prevented a marked rise in heart rate and mean arterial pressure associated with laryngoscopy and orotracheal intubation.
ABSTRACT
BACKGROUND: A double blind randomized prospective study was undertaken to determine the effect of adjuncts like epinephrine 200µg or clonidine 90µg in combination of bupivacaine and lignocaine into the brachial plexus sheath to study the sensory and motor onset, duration of analgesia, hemodynamic changes and adverse effects. PATIENTS #ENTITYSTARTX00026; METHODS: 60 patients aged 18-65 years, with ASA grade I and II were randomly divided into group I and group II to receive 10 ml of lignocaine2% and 20 ml of bupivacaine0.5% with 1ml of 200µg epinephrine or 90µg clonidine respectively. Onset of sensory blockade was determined by pinprick method by a three point score and motor blockade by three point scale. Duration of postoperative analgesia, the hemodynamic changes, sedation scores and any adverse effects were observed. Statistical analysis was done by student's "t" test and p<0.05 was considered significant. RESULTS: It was found that there was faster onset of sensory and motor blockade, the postoperative analgesia was prolonged and the amount of sedation was profound in group II as compared to group I. All the above findings were statistically significant. CONCLUSION: We thereby conclude that clonidine 90µg is a better option as an additive than epinephrine 200µg for hastening the onset of sensory and motor block with prolonged postoperative analgesia and sedation as the only adverse effect.
