Comparison of the efficacy of lornoxicam and fentanyl in attenuating the hemodynamic response to laryngoscopy and intubation

BACKGROUND AND OBJECTIVES: Laryngoscopy and intubation elicits huge spectrum of stress response which is hazardous in high-risk patients. Many drugs and techniques have been used to attenuate the stress response. Lornoxicam 16 mg is a potent nonsteroidal anti-inflammatory drug agent with analgesic potency equivalent to morphine 10 mg, fentanyl 100 μg and tramadol 100 mg. Lornoxicam has been found to attenuate stress response in some studies. We compared the lornoxicam with fentanyl in attenuating stress response. MATERIALS AND METHODS: A double blind randomized controlled study was conducted on 60 adult patients of American Society of Anesthesiologist physical status 1 and 2. Group L (n = 30) receives injection lornoxicam 16 mg intravenous 30 min before induction, Group F (n = 30) receives injection fentanyl 2 μg/kg during induction. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) were recorded baseline (BL), before induction, every minute up to 5 min and at 10 min after intubation. RESULTS: After intubation, there is a gradual decrease in SBP and DBP in both groups. The MAP was also comparable between the two groups except at 5 min and 10 min during which MAP recovered toward BL in Group L where as it remained low in Group F which was statistically significant (P < 0.05). Both the drugs have successfully attenuated the HR response. CONCLUSION: Lornoxicam successfully attenuated the hemodynamic response to laryngoscopy and endotracheal intubation and is equally efficacious as fentanyl.