Perfusion Index to Assess Hemodynamic Changes and Analgesia with Premedication of Fentanyl versus Nalbuphineduring General Anesthesia:

Kumkum Gupta; Bhawana Rastogi; Prashant K Gupta; Manoranjan K Bansal; Pavitra Kalra; Sukhreet Kaur

doi:10.21276/aan.2019.4.2.57

Kumkum Gupta Professor, Department of Anaesthesiology and Critical care
Bhawana Rastogi Professor, Department of Anaesthesiology and Critical care
Prashant K Gupta Director Professor, Department of Radio diagnosis and Imaging
Manoranjan K Bansal Assistant Professor, Department of Anaesthesiology and Critical care
Pavitra Kalra Resident, Department of Anaesthesiology and Critical care, Subharti Medical College, Partapur Bye Pass Road, Meerut-UP, India
Sukhreet Kaur Resident, Department of Anaesthesiology and Critical care, Subharti Medical College, Partapur Bye Pass Road, Meerut-UP, India

DOI: https://doi.org/10.21276/aan.2019.4.2.57

Keywords: Perfusion Index, Hemodynamic changes, Fentanyl, Nalbuphine, Pain

Abstract

Background: The hemodynamic changes are part of stress responses of airway manipulation and surgical pain, which are manifested as tachyarrhythmia and hypertension, and should be ameliorated. This study compared the hemodynamic changes and analgesia with premedication of fentanyl versus nalbuphine during general anesthesia, using perfusion index technique, a non-invasive parameter.Subjects and Methods:After approval, 60 patients of ASA physical status I and II aged between 26 to 56 years of either gender were randomized in two groups of 30 patients each to receive either intravenous fentanyl 2g/kg (Group F) or nalbuphine 0.2 mg/kg (Group N), 5 min before induction with propofol. Direct laryngoscopy and intubation was facilitated with vecuronium bromide (0.1 mg/kg). Hemodynamic changes and intraoperative analgesia were recorded at specific time intervals, as primary objectives. Any side effects or complications were noted as secondary outcome.Results:After airway manipulation, the increase in heart rate and systolic blood pressure with decreased perfusion index occurred immediately in patients of both groups which persisted up to 6 to 10 min, thereafter the changes returned back to baseline value with statistically significant difference between both groups. At the time of surgical incision, nalbuphine showed better analgesic effect than fentanyl as assessed by perfusion index. No significant correction between perfusion index and heart rate was observed but there was statistically significant negative correlation between perfusion index and systolic blood pressure.Conclusion: Intravenous fentanyl was more effective for ameliorating the stress response of airway manipulation while nalbuphine was better for intraoperative analgesia as assessed by perfusion index.

Downloads

Download data is not yet available.