Comparison of efficacy of labetalol and fentanyl for attenuating reflex responses to laryngoscopy and intubation

Mymensingh Med J. 2014 Apr;23(2):242-8.

Abstract

Stress response due to laryngoscopy and intubation has been universally recognized phenomenon resulting in increase in heart rate, arterial, intracranial, and intraocular pressure. Various pharmacological approaches have been used to blunt or attenuate such pressure responses. This prospective, randomized, placebo controlled, double blinded study was designed to compare the efficacy of bolus dose of Labetalol and Fentanyl for attenuating reflex responses to laryngoscopy and intubation. Ninety patients with physical status of ASA I and II were scheduled for elective surgery under standard protocol of general anaesthesia, randomly allocated into three groups, consisting of 30 patients in each group, assigned as C (Control), L (Labetalol), and F (Fentanyl). In control group 10ml of 0.9% saline, in Labetalol group 0.25 mg/kg Labetalol and in Fentanyl group 2μgm/kg of Fentanyl were given intravenously at 3 minutes prior to laryngoscopy and intubation. Pulse rate, systolic, diastolic, mean arterial pressure and rate pressure products (RPP) were recorded before and after premedication, after administration of study drugs and at 1, 3, 5, 10 and 15 minutes after intubation. For statistical analysis of data, ANOVA tests were performed for comparison between groups. There were an increase in heart rate, systolic, diastolic, mean arterial pressures and rate pressure product in all the three groups after intubation in comparison to base line value. But the rise was minimum in L and F group as compared to C group which is statistically significant and also minimum in L group as compared to F group. So Labetalol is better agent for attenuation of laryngoscopic and intubation reflex.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adrenergic Antagonists / therapeutic use*
  • Adult
  • Anesthetics, Intravenous / therapeutic use*
  • Blood Pressure / drug effects
  • Double-Blind Method
  • Female
  • Fentanyl / therapeutic use*
  • Heart Rate / drug effects
  • Humans
  • Intubation / adverse effects
  • Labetalol / therapeutic use*
  • Laryngoscopy / adverse effects*
  • Male
  • Middle Aged
  • Prospective Studies
  • Reflex / drug effects*
  • Young Adult

Substances

  • Adrenergic Antagonists
  • Anesthetics, Intravenous
  • Labetalol
  • Fentanyl