COMPARISON OF INTRAVENOUS LIGNOCAINE VS NALBUPHINE IN ATTENUATION OF HEMODYNAMIC RESPONSE TO AWAKE TRACHEAL EXTUBATION IN ENT SURGERIES

Abstract

Objective: To compare intravenous lignocaine vs. intravenous nalbuphine in terms of mean change in heart rate and mean arterial pressures (MAP) during awake tracheal extubation. Study Design: Randomized control trial. Place and Duration of Study: Main Operation Theatre, Combined Military Hospital Rawalpindi, from May 2016 to Dec 2016. Methodology: After approval of the study by the institution’s research ethics committee, the patients meeting inclusion criteria were assigned randomly to one of the two groups by lottery method. On return of spontaneous ventilation, patients in group L received intravenous lignocaine 1.5 mg/kg while group N patients received intravenous Nalbuphine 0.2mg/kg. Data recorded immediately (T1) and 5min after (T2) extubation. Results: After stratification of data in terms of age, gender, duration of surgery and ASA classification, evaluation of hemodynamic parameters (HR and MAP) between the two groups was done. The mean change in HR in group L was 6.66 ± 1.53 bpm and in group N was 4.43 ± 1.35. The mean change in MAP in group L was 4.90 ± 1.49 mm of Hg and in group N was 3.23 ± 1.33. p-value in both parameters was found to be less than 0.05 and thus declared significant. Conclusion: We concluded that intravenous nalbuphine, in the dose of 0.2mg/kg, is a better attenuator of hemodynamic response to extubation as compared to intravenous lignocaine and provides better stability of Heart rate and Mean arterial Pressure.

Keywords

• airway extubation
• hemodynamics
• lignocaine
• mean arterial pressure
• nalbuphine
• pulse