Attenuation of Haemodynamic Response to Laryngoscopy and Endotracheal Intubation Using Intra-Oral Ivabradine: A Clinical Study

Raghuram, C. G.; Singh, D.; Kabra, Aditya Vikram

doi:10.14260/jemds/2014/3289

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…This aspect of ivabradine has been explored in some recent studies and excellent results have been obtained. 5,[11][12][13] The dose of ivabradine (2.5 mg) used in our study gave a controlled field and did not cause any sudden drop-in HR.…”

Section: Discussionmentioning

confidence: 99%

“…"If " blockade results in a decrease in the slope of spontaneous depolarization, leading to an increase in the time interval between successive action potentials in the SA node, thus decreasing the HR. 5 Ivabradine decreases the HR without any inordinate change in hemodynamics of unhealthy, compromised patients. The drug can be used both in hypertensive and normotensive patients.…”

Section: Introductionmentioning

confidence: 99%

“…Hence, in every aspect, ivabradine is an ideal drug to be used during general anesthesia procedures in view of its multiple benefits on the myocardium. 5 Although ivabradine is commonly used in critical care setup to reduce HR, its use intraoperatively during surgeries has not been explored sufficiently except for its effect to attenuate hemodynamic response during laryngoscopy and intubation.…”

Section: Introductionmentioning

confidence: 99%

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Effect of oral premedication with ivabradine on surgical field and intraoperative bleeding during functional endoscopic sinus surgeries: A prospective, randomized, and placebo-controlled study

Iyengar

Kumar²,

Kantharaju

2023

Asian J Med Sci

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Background: Ivabradine is an effective drug to prevent abnormal increase in heart rate (HR). Aims and Objectives: The aims of this study were to determine if a pre-operative oral dose of ivabradine (2.5 mg) reduces intraoperative bleeding during functional endoscopic sinus surgery (FESS) and improves visualization of operative field. Materials and Methods: A prospective, randomized, and placebo-controlled study was carried out in 30 patients of ASA grade I and II, aged between 18 and 60 years undergoing FESS surgeries. The patients were randomly allocated into two groups. Group I – received 2.5 mg of tablet ivabradine and Group P – received a placebo (vitamin tablet) 1 h before surgery. Blood loss and hemodynamic parameters (HR, systolic, diastolic, and mean blood pressure) were assessed perioperatively. Surgical field was graded by operating surgeon using Fromme – Boezaart score (FBS) at the end of procedure. Post-operative monitoring for any complications was also done. Results: Mean final blood loss in Group I was 165.73±43.48 mL and in Group P was 246.25±30.76 mL. There was a significant difference in mean final blood loss (mL) between two groups with P<0.001. In Group I – 13.33% had FBS 1 and 86.67% had FBS 2, whereas in Group P – 6.67% had FBS 2, 86.67% had FBS 3, and 6.67% had FBS 4. Thus, Group I had lower FBS scores than Group P and was statistically significant. Conclusion: Pre-operative oral ivabradine helps in reducing intraoperative bleeding in FESS surgery and provides good surgical field compared to placebo.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of oral premedication with ivabradine on surgical field and intraoperative bleeding during functional endoscopic sinus surgeries: A prospective, randomized, and placebo-controlled study

Iyengar

Kumar²,

Kantharaju

2023

Asian J Med Sci

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“…Reflex cardiovascular effects of laryngoscopy and intubation in anesthetized patients have been described previously. [8] These reflex changes which include the rise in arterial pressure (SBP, DBP, MBP) and heart rate are at their peak approximately 30-45 sec after laryngoscopy.Attempts to attenuate these responses by various drugs or techniques or their combinations have met with varying success. In this study, both the study group and control group cases received the same pre-medications.…”

Section: Discussionmentioning

confidence: 99%

Attenuation of Haemodynamic Response To Laryngoscopy And Intubation With Nitroglycerin

Srivani

2021

Persp Med Res

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Background: Laryngoscopy and intubation are common procedures in anesthesia. Hemodynamic responses to mechanical stimulation of the laryngopharynx and tracheobronchial tree cause stimulation of sympathetic efferent fibres leading to an increased pressor response. We in the current study tried to evaluate the effect of nitroglycerine in the attenuation of hemodynamic responses due to laryngoscopy and intubation. Methods : Based on the inclusion and exclusion criteria n=80 cases were divided into two groups Group A (n=40) control group and group B (n=40) study group randomly by computergenerated number. A detailed history is taken and a complete physical examination is performed and the presence of any medical disorder and history of drug intake was ruled out. All patients were screened by radiological, biochemical, and histological investigations, in addition to routine pre-operative ECG.Pre-medication, induction agent and muscle relaxant to facilitate intubation was standardized for both groups. Results: The parameters recorded in the control group at one minute showed hemodynamic values were increased. The difference of SBP with the study group was 14.75 mm Hg, diastolic blood pressure by 5 mm Hg, mean blood pressure by 8.5 mm Hg, HR was 8 beats per minute al these values were pvalues <0.05 hence considered significant. At the end of three minutes, the comparison shows all the parameters SBP, DBP, MBP, HR, and RPP still increased significantly in the control group as compared to the test group. At the end of five minutes, all the parameters were found to still significantly higher in the control group (<0.05) as compared to the study group except for SBP change which was found not to be significant between both the groups. Conclusion: The study establishes the usefulness of intravenous Nitroglycerine to attenuate hemodynamic to laryngoscopy and tracheal intubation. The hemodynamic changes in the study group were well within the limits as compared to the control group. The study also shows that there were no incidences of adverse effects with nitroglycerine. Therefore, nitroglycerine must be considered for attenuation of hemodynamic responses to laryngoscopy in cases where it is indicated.

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“…Raghuram et al [29] evaluated the efficacy of oral ivabradine to attenuate the hemodynamic responses after intubation. They found that ivabradine is an extremely useful drug to prevent abnormal increase in heart rate and blood pressure to a lesser extent seen during laryngoscopy and endotracheal intubation and recommended its routine use in all patients at risk for hypertension and tachycardia during laryngoscopy and endotracheal intubation.…”

Section: Discussionmentioning

confidence: 99%

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

Ibrahim

Atallah

2016

Egyptian Journal of Anaesthesia

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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). No significant difference (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.

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Attenuation of Haemodynamic Response to Laryngoscopy and Endotracheal Intubation Using Intra-Oral Ivabradine: A Clinical Study

Cited by 5 publications

References 20 publications

Effect of oral premedication with ivabradine on surgical field and intraoperative bleeding during functional endoscopic sinus surgeries: A prospective, randomized, and placebo-controlled study

Effect of oral premedication with ivabradine on surgical field and intraoperative bleeding during functional endoscopic sinus surgeries: A prospective, randomized, and placebo-controlled study

Attenuation of Haemodynamic Response To Laryngoscopy And Intubation With Nitroglycerin

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

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