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Research Paper | Anaesthesiology | India | Volume 11 Issue 11, November 2022
Nalbuphine Compared with Fentanyl for Attenuation of Pressor Response in Laparoscopic appendicectomy-A Randomized Double blind Clinical Trial
Dr. Mahendrakar Sreevani  | Dr. Rajapriya .R  | Dr. Srinivasa Rao .N
Abstract: Background In this study, our primary aim was to compare the efficacy of fentanyl and nalbuphine in attenuating the pressor response to laryngoscopy and tracheal intubation in patients undergoing laparoscopic appendicectomy under general anesthesia. The secondary aim was to observe hemodynamic response to pneumoperitoneum and to study the level of sedation using the Richmond Agitation-Sedation Scale (RASS). Methodology A total of 80 patients belonging to the American Society of Anesthesiologist Physical Status class I/II scheduled to undergo elective laparoscopic appendicectomy under general anesthesia were divided into two groups of 40 each. group A received intravenous nalbuphine 0.2 mg/kg and group B received intravenous fentanyl 2 ?g/kg, five minutes before induction of anesthesia. Technique of anesthesia was standardized for all patients in the study. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded before giving the study drug; before induction; immediately after intubation; at one, three, and five minutes after intubation; before creating pneumoperitoneum; 15 minutes after creating pneumoperitoneum; and five minutes after release of pneumoperitoneum. Preoperative and postoperative sedation scoring was done using RASS. Results Immediately after intubation, HR was significantly higher in group A (p = 0.02). Both groups showed a rise in SBP immediately after intubation. Group A showed a significantly higher SBP, DBP, MAP in comparison to group B ( 136.58 ? 10.55, 80.23 ? 7.88, 99.01? 8.01,and 125.23 ? 9.12, 73.8 ? 8.86, 94.61? 8.85.; ) respectively . At one, three, and five minutes after intubation, HR, SBP, DBP, and MAP were similar between the groups. Post-extubation sedation score was significantly higher in group A (p < 0.001). Conclusions We found that fentanyl was more effective than nalbuphine in attenuating the pressor response to laryngoscopy and tracheal intubation.
Keywords: Fentanyl, Nalbhuphine, pressor response, laparoscopic appendicectomy, laryngoscopy, General anaesthesia, Hemodynamic response
Edition: Volume 11 Issue 11, November 2022,
Pages: 1227 - 1230
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