Study Comparing Nalbuphine and Fentanyl Effects on Heart and Blood Pressure During Heart Surgery with Cardiopulmonary Bypass in Adults Aged 40 to 60

What this Trial Is About

This research aims to compare the effects of two opioid drugs, nalbuphine and fentanyl, on the heart and blood pressure responses during laryngoscopy in patients undergoing cardiac surgery with cardiopulmonary bypass. The study is a randomized, double-blinded interventional trial conducted in adults aged 40 to 60 years who are classified as ASA III and undergoing this specific type of surgery. It is conducted by the Rawalpindi Institute of Cardiology and focuses on managing hemodynamic changes during anesthesia. Participants will receive oral alprazolam the night before surgery and have intravenous access established in the recovery area. In the operating room, standard monitoring and the insertion of a central venous catheter and arterial line will be done under local anesthesia. Before anesthesia induction, patients will receive premedication including midazolam and an opioid analgesic, either nalbuphine 0.2 mgkg or fentanyl 3 microgramskg, given slowly through the vein over 5 minutes. General anesthesia will be induced with etomidate, followed by muscle relaxation with atracurium and ventilation with oxygen. Anesthesia will be maintained with oxygen, sevoflurane gas, and continuous atracurium infusion during surgery. Participants will be closely monitored for heart rate and blood pressure before drug administration, immediately before intubation, and at 1, 3, 5, and 15 minutes after intubation. The study includes routine preoperative assessments and continuous intraoperative monitoring of vital signs and hemodynamic parameters. The total duration of involvement covers preoperative preparation, anesthesia induction, surgery, and monitoring during and shortly after intubation to assess the effects of the drugs on cardiovascular stability.

Effect of Nalbuphine Versus Fentanyl on Hemdoynamic Effects of Laryngoscopy