Comparative study of oral Ivabradine and oral Metoprolol as single dose preoperative agent for maintaining hemodynamic stability in oral and maxillofacial surgeries

Abstract

Aim: To analyse and compare the effect of Single Dose oral Ivabradine and oral metoprolol as
preoperative agent in maintaining hemodynamic stability in oral and maxillofacial surgeries.
Material and methods: This prospective, double blind, randomized, comparative, hospitalbased study conducted in the Department of Anesthesiology, IMS & SUM Hospital medical
college on 60 patients undergoing oral and maxillofacial surgery. Patients were randomly
divided into 2 groups-30 patients in each group using chit and box method i.e. Group A-Tab
Ivabradine (5 mg) given orally 2 hours before induction of anesthesia and Group B-Tab
Metoprolol tartrate (50 mg) given orally 2 hours before induction of anaesthesia. Heart rate,
systolic blood pressure, diastolic blood pressure, mean arterial pressure levels were recorded
i.e. at baseline, just after intubation, 1, 3, 5, 10, 15, 30, 45, 60, 90 minutes and just after
extubation. Blood sugar level was recorded before intubation, just after intubation, at an
interval of 1 hour intraoperatively and just after extubation.
Results: After comparing both the groups, SBP values at 1min, 3min, 5min, 10min, 15min,
30min, after extubation, were statistically significant. After comparing both groups MAP
values at1 min, 3 min, 5 min, 10 min, 15 min, 30 min, 45 min and after extubation were
statistically significant. Mean blood glucose just after extubation in Group A was 112.68±6.31
mg/dl, in Group B was 110.00±5.23 mg/dl.
Conclusion: Ivabradine was found to have better control than metoprolol in controlling the HR
while metoprolol have better control on SBP, DBP and MAP. Blood glucose comparison
between two groups shows that there was no significant difference. Ivabradine can be
recommended in cases where beta blockers are contraindicated like in bronchial asthma.