COMPARISON OF MIDAZOLAM AND NALBUPHINE IN REDUCING HAEMODYANIMIC RESPONSE TO ENDOTRACHEAL INTUBATION
Main Article Content
Keywords
Nalbuphine, Midazolam, Hemodynamic response, Endotracheal intubation, Heart rate, Mean arterial pressure
Abstract
Background
Endotracheal intubation often triggers marked cardiovascular changes such as an increase in heart rate and blood pressure, which can be harmful, especially in patients with cardiovascular disease. Midazolam and nalbuphine are both used in clinical practice to blunt these hemodynamic responses, but their relative effectiveness remains uncertain.
Objective
This study aimed to compare the effects of midazolam and nalbuphine on heart rate and mean arterial pressure (MAP) three minutes after endotracheal intubation.
Duration and place of study: this study was conducted at Civil Hospital Hyderabad / Liaquat University of Medical & Health Sciences Jamshoro from January 2025 to July 2025
Methods
A total of 202 patients scheduled for elective surgery were enrolled in this randomized controlled trial. They were randomly divided into two equal groups. Group A received intravenous midazolam (30 µg/kg), while Group B received intravenous nalbuphine (75 µg/kg). Baseline heart rate and MAP were recorded before induction, and the same parameters were measured three minutes after intubation. Data were analyzed using SPSS version 16, with a significance level set at p<0.05.
Results
The mean age of participants was 39.36 ± 12.95 years, with 122 males (60.4%) and 80 females (39.6%). A significant difference was observed between the two groups. Patients who received nalbuphine showed lower mean heart rate and MAP compared with those given midazolam (96.99 vs. 94.62 beats/min, p=0.035; 109.16 vs. 105.90 mmHg, p=0.001).
Conclusion
Nalbuphine proved to be more effective than midazolam in controlling the hemodynamic response to endotracheal intubation. Its use may therefore help achieve better cardiovascular stability during the induction of anesthesia.
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Ashique Mehdi
Ashique Mehdi, Chief Medical officer Anesthesiology and Intensive Care, Civil Hospital Hyderabad / Liaquat University of Medical and Health Sciences Jamshoro Pakistan.
Kelash Kumar
Kelash Kumar, Assistant professor Anesthesiology and Intensive Care, Liaquat University of Medical & Health Sciences Jamshoro Pakistan.
Ali Haider
Ali Haider, Senior Medical officer Anesthesiology and Intensive Care, Civil Hospital Hyderabad / Liaquat University of Medical and Health Sciences Jamshoro Pakistan.
Ahmed Khan
Ahmed Khan, Assistant Professor Anesthesiology and Intensive Care, Liaquat Institute of Medical & Health Sciences Thatta (LIMHS) Pakistan.
Wajiha Tahir
Wajiha Tahir, Medical Officer, Liaquat National Hospital Karach Pakistan.
Maqsood Ahmed Siddiqui
Maqsood Ahmed Siddiqui, Associate Professor & Head of Department of Anesthesiology, Surgical ICU & Pain Management, Ghulam Muhammad Mahar Medical College Sukkur Pakistan.