Hemodynamic Response to Laryngoscopy and Endotracheal Intubation by Using Oral Ivabradine

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Hemodynamic Response to Laryngoscopy and Endotracheal Intubation by Using Oral Ivabradine

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Introduction: Laryngoscopy gives rise to a stress response that is seen as rise in heart rate and blood pressure and as dysrhythmia. Such changes are at peak immediately after intubation and can be dangerous for those having already limited or compromised cardiovascular reserve. They can lead to increased risk of myocardial infarction (MI), stroke, congestive cardiac failure or sudden death. Aims and Objectives: To study the effect of oral Ivabradine in attenuating the hemodynamic stress response to laryngoscopy; and to endotracheal intubation and extubation. Materials and Methods: A randomized double blinded study was done. Total number of 140 patients (adult patients undergoing ENT surgery) were randomly taken into two Groups. The first group was labelled as Test Gropu (A) and the second group was called Control Group (B). Each group had 70 patients. The Test group (A) received 5 mg oral Ivabradine and the Control group (B) received placebo. Patients were monitored for hemodynamic changes as per the protocol. Result: Mean heart rate, SBP, DBP and MAP reading at intubation, post-intubation period till 10 mins, at extubation and till 10 minutes post-extubation were significantly less in test group i.e. in patients who received oral Ivabradine as compared to control group (p<0.05). Conclusion: We conclude that Ivabradine is an extremely useful drug to prevent abnormal tachycardias during the procedure of laryngoscopy and intubation. Its stabilizing effect of haemodynamics also extends up to extubation and immediate post-operative period.

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