Ivabradine versus propranolol given orally in microlaryngoscopic surgeries in attenuating stress response: A comparative prospective double blind randomized study

Abstract

Background and objective: In this study we evaluated oral ivabradine (a relatively new heart rate lowering agent) versus oral propranolol (a classic commonly used beta-blocker) in achieving a hemodynamic stability and controlling possible changes in blood glucose level due to stress response in microlaryngoscopic surgeries. Methods: A total of 50 American Society of Anesthesiologists (ASA) 1,2 patients scheduled for microlaryngoscopic surgeries were included in this prospective, randomized controlled double blind study. They were given either oral ivabradine (5 mg tablet) group I or oral propranolol (10 mg tablet) group P in the evening before the operation and 1 h before the induction of anesthesia. Hemodynamic variables (systolic, diastolic, mean blood pressure and heart rate) and blood glucose level were recorded perioperatively. Results: The changes in blood pressure and heart rate in both groups were mild after intubation, laryngoscope fixation for surgery and extubation but these changes in ivabradine group were significantly less than the changes in propranolol group (P 0.05) was found between both groups in blood glucose level perioperatively. No statistically significant complications were observed in both groups. Conclusion: Premedication with 5 mg of oral ivabradine or 10 mg of oral propranolol before microlaryngoscopic surgeries was effective in achieving a good degree of hemodynamic stability but ivabradine was more effective. Both drugs didn’t show an obvious effect on blood glucose level perioperatively. No complications were recorded.

Keywords

• Microlaryngoscopic surgeries
• Ivabradine
• Propranolol
• Stress response