A Comparative Evaluation of 5 mg and 10 mg Oral Ivabradine for Preventing the Hemodynamic Response to Laryngoscopy and Endotracheal Intubation

Abstract

Objective: To evaluate and compare the hemodynamic effects of 5 mg and 10 mg oral Ivabradine during laryngoscopy and intubation. Methods: This prospective, comparative clinical study included 110 patients aged 18-60 years scheduled for elective surgeries under general anesthesia. Patients were equally divided to receive either 5 mg (Group A) or 10 mg (Group B) of oral Ivabradine one hour before induction. Hemodynamic parameters were recorded at baseline, intraoperatively, and at post-intubation time intervals. Results: Baseline parameters were comparable between both groups with insignificant statistical differences (p>0.05). While, after intubation, Group B demonstrated significantly better reduction of the hemodynamic stress response, showing a significantly lower mean heart rate, systolic and diastolic blood pressure, and mean arterial pressure from immediate post-intubation up to 20 min compared to Group A (p<0.0001). Perfusion Index remained comparable and stable across both groups. Group B also exhibited a significantly lower incidence of postoperative nausea, vomiting, and bradycardia. Conclusion: A 10 mg dose of preoperative oral Ivabradine provides superior, safe, and dose-dependent reduction of the hemodynamic stress response to laryngoscopy and endotracheal intubation compared to a 5 mg dose without compromising peripheral perfusion.