ATTENUATION OF HAEMODYNAMIC RESPONSE TO ENDOTRACHEAL INTUBATION WITH NALBUPHINE AND FENTANYL: A COMPARATIVE STUDY

BACKGROUND: Endotracheal intubation is a most noxious stimuli in anaesthesia in form of tachycardia and hypertension. Many drugs have been tried to attenuate these adverse hemodynamic responses, but no ideal drug has been discovered. We compare the effect of fentanyl and nalbuphine on modifying the hemodynamic response to laryngoscopy and tracheal intubation. METHODS: Two randomly assigned groups of 40 patient each, aged 20-60 years, were scheduled for elective surgery receive Group 1 inj. Fentanyl 2ug/kg or GROUP 2 inj. Nalbuphine 0.2mg/kg iv 5min before laryngoscopy and intubation. Haemodynamic parameters and post-operative complications were recorded. RESULTS: Immediately after drug administration, the heart rate (HR) in group I decreased from basal value of 85.55 +/- 10.85bpm to 83.75 +/- 14.11bpm, in group II increased from basal value of 89.83 +/- 1.48bpm to 95.33 +/- 16.99bpm (p<0.05). The decrease in mean SBP was in both the groups, but more in group II. Immediately after drug administration decrease in DBP was in both the groups, which was more in group I than group II (p<0.05) it persisted in group II at 15 and 30 min after intubation, while group I showed an increase in DBP (p<0.05). After intubation, mean MAP increased from baseline in group I than group II observed a decrease in mean MAP from baseline (p>0.05) and it values at 5, 15, 30 min after intubation were lower in group II as compared to group I were significant (p<0.001). CONCLUSION: Nalbuphine controls the pressor response much better as compared to Fentanyl.