To Evaluate The Use Of Ivabradine In Prevention Of Hemodynamic Response To Laryngoscopy And Intubation
An increase in blood pressure and increased heart rate is commonly associated with laryngoscopy and intubation if done before attaining an adequate depth of anaesthesia. However failure to counteract the catecholamine response to intubation may have disastrous consequences. In patients with hypertension, increased intracranial pressure, aneurysmal vascular disease, and diseased cerebral vasculature or ischemic heart disease, additional care has to be taken while intubating. Hence, we performed a study to optimize the hemodynamics prior to laryngoscopy and intubation.METHODS AND MATERIALS- This is a prospective randomized controlled trial that included 60 patients divided into two groups- I and II. The study included of patients aged 18-60 years, both males and females, weighing between 50-70 kgs, belonging to ASA class I/II. The study excluded those patients with Hypersensitivity to ivabradine, Resting heart rate below or equal to 60 beats per minute, SA and AV block patients, Patient on antihypertensive medications, Patient with severe hepatic insufficiency and Pregnant females and lactating mothers.
Drug—Ivabradine in 2.5mg and 5 mg doses
Each patient underwent a thorough preanaesthetic examination and all routine laboratory test including hemogram, coagulogram, biochemical indices, X-Ray chest and ECG and other special investigations if necessary.RESULTS-
There was a statistically significant difference in the SBP, MBP and DBP at 30 and 45 minute duration post administration of IVABRADINE 5 mg when compared to 2.5 mg. However, there was no significant alteration in SpO2 and EtCO2.CONCLUSION-
IVABRADINE is a safe drug administered prior to the laryngoscopy and intubation as it ensures optimal hemodynamics throughout the procedure.