Comparison of intravenous nalbuphine and dexmedetomidine in combination with lidocaine aerosol inhalation in awake direct laryngoscopy: a randomized, double-blind, placebo-controlled trial
Authors' conclusion
Intravenous nalbuphine in combination with lidocaine aerosol inhalation significantly improved patient tolerance and satisfaction while reducing nausea, coughing, pain, sedation, and SpO2 levels during ADL.
Study context
- Population
- Patients scheduled for GA undergoing awake direct laryngoscopy (ADL)
- Participants
- 60 patients
- Comparison
- IV nalbuphine 0.15 mg/kg or dexmedetomidine 0.75 μg/kg vs placebo, all with nebulized lidocaine, before awake direct laryngoscopy
- Dexn = 20
- Naln = 20
- Controln = 20reference
- Primary endpoint
- Patient tolerance (5-point ADL comfort score)
Methodological detailsdouble-blind, placebo-controlled
- Double-blind
- Placebo-controlled
Primary result
As reported in the abstract
Nal
4
Control
3
Dex
2
Nal vs control: P < 0.017 · Nal vs Dex: P < 0.001
Secondary outcomes
| Outcome | Dex | Nal | Control | P value |
|---|---|---|---|---|
| SatisfactionNal vs control · higher satisfaction in Nal | 5.5 | 7 | 4 | P < 0.017 |
| SatisfactionNal vs Dex · higher satisfaction in Nal | P < 0.001 | |||
| Sedation score and SpO2Nal vs Dex · significantly higher in Nal | P < 0.001 | |||
| Sedation score and SpO2Nal vs control · no difference | P = 0.159 |
Safety
- Significantly fewer adverse events, such as pain and nausea, in Nal than in control and Dex
Original publication
Comparison of intravenous nalbuphine and dexmedetomidine in combination with lidocaine aerosol inhalation in awake direct laryngoscopy: a randomized, double-blind, placebo-controlled trial. Perioper Med (Lond). Published 19 October 2024. doi:10.
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