Effect of Nalbuphine on Hemodynamic Response During Laryngoscopy and Intubation

Laryngoscopy and placement of a breathing tube during general anesthesia can cause temporary increases in blood pressure and heart rate. These changes may be harmful in some patients. Nalbuphine is an opioid pain medicine that may reduce these cardiovascular responses. This study evaluated whether intravenous nalbuphine, given before anesthesia induction, reduces changes in mean arterial blood pressure during laryngoscopy and orotracheal intubation compared with placebo (normal saline). Adult patients undergoing elective surgery under general anesthesia were randomly assigned to receive either nalbuphine or placebo before anesthesia. Blood pressure was measured before drug administration, during intubation, and for several minutes afterward. The results of this study may help guide safe medication use to maintain blood pressure stability during airway management.

Inclusion Criteria * Patients scheduled for elective surgery under general anesthesia requiring laryngoscopy and orotracheal intubation. * American Society of Anesthesiologists (ASA) physical status I or II. * Age between 18 and 60 years. * Male and female patients. * Patients who provide written informed consent. Exclusion Criteria * Known hypersensitivity to nalbuphine or any opioids. * History of cardiovascular disease, including uncontrolled hypertension, arrhythmias, or ischemic heart disease. * Respiratory disorders such as asthma, chronic obstructive pulmonary disease, or significant respiratory compromise. * Renal or hepatic impairment. * Pregnancy or lactation. * Use of medications affecting hemodynamic response (e.g., beta-blockers or calcium channel blockers). * Emergency surgery. * Anticipated difficult airway (Mallampati class III or IV).