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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 1, Jan-Feb 2019, Pages 235-241
 

Original Article

Study on Oral Nebivolol in Attenuating the Cardio Vascular Responses to Laryngoscopy and Endotracheal Intubation

Anil Kumar Akkenapalli

Associate Professor, Department of Anesthesiology, Gandhi Medical College/ Gandhi hospital, Secunderabad, Telangana 500003, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.33

Abstract

Introduction: Laryngoscopy and intubation are almost always associated with hemodynamic changes due to sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation. Aim: To study the efficacy of oral Nebivolol in attenuating the cardio vascular reflex responses to laryngoscopy and endotracheal intubation. Materials and methods: The attenuation of cardiovascular reflex responses to laryngoscopy and endotracheal intubation has been done with oral nebivolol, a long acting beta-1 blocker in 25 healthy ASA grades 1 patients of both sexes b/w age groups 25-60 yrs. and compares with 25 others in the same age group, termed as control. The study group receives oral nebivolol 5 mg once daily for those below 50 kgs. In the premedication inj. Glycopyrolate 0.2 mg IM and inj. Ketorolac 1 mg/kg IM was given in both groups, inj. Glycopylate was preffered over injection atropine as it has better antisecretory properties with minimal cardiac effects, which would change basic monitoring values. Results: Laryngoscopy and endotracheal intubation there was significant increase in blood pressure (SAP, DAP and MPA) and heart rate in the control group, but was significantly less in the study who received the beta blocker nebivolol. In control group rate pressure product, a measure of myocardial oxygen demand was increased significant after laryngoscopy and endotracheal intubation. Conclusion: Hence, because of long duration of action and being beta, selective agent, oral nebivolol agent when used prior to surgery ensures a stable normotensive or a mild hypotensive field during surgery.


Keywords : Nebivolol; Laryngoscopy; Endotracheal Intubation.
Corresponding Author : Anil Kumar Akkenapalli