A Comparative Study Of Midazolam-Fentanyl And Midazolam-Pentazocine For Hemodynamic Control During Laryngoscopy And Intubation

Context: Laryngoscopy and intubation are crucial yet noxious stimuli that provoke significant hemodynamic changes. Effective attenuation of these responses is vital, particularly in high-risk patients. This study compares the hemodynamic effects of midazolam-fentanyl and midazolam-pentazocine combinations during laryngoscopy and intubation. Aims: To evaluate and compare the efficacy of midazolam-fentanyl and midazolam-pentazocine in attenuating heart rate, blood pressure, rate pressure product, mean arterial pressure and maintaining oxygen saturation during airway management. Settings and Design: A prospective, randomized controlled study conducted at a tertiary care hospital. Methods and Material: Sixty ASA grade I or II patients aged 18–60 years undergoing elective surgeries under general anaesthesia were randomized into two groups: Group F (midazolam 0.03 mg/kg + fentanyl 2 µg/kg) and Group P (midazolam 0.03 mg/kg + pentazocine 0.6 mg/kg). Hemodynamic parameters were recorded at baseline, pre-induction, and at five intervals up to 10 minutes post-intubation. Statistical analysis used: Inter-group comparisons were conducted with t-tests and the Chi-square test; intra-group changes were analysed using repeated measures ANOVA, with p<0.05 considered significant. Results: Group F showed significantly lower HR, BP, and RPP compared to Group P, particularly during induction and the immediate post-intubation phase (p<0.05). Group P exhibited higher fluctuations, indicating less haemodynamic stability. Oxygen saturation remained comparable between groups (p>0.05). Conclusions: Midazolam-fentanyl demonstrated superior attenuation of hemodynamic responses compared to midazolam-pentazocine, making it a preferred option for patients requiring stable cardiovascular parameters during airway management. Future studies could explore strategies to enhance the efficacy of pentazocine in such contexts.