A Randomized Study of Esmolol to Attenuate The Hemodynamic Stress Response During Laryngoscopy And Endotracheal Intubation.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 7
Abstract
INTRODUCTION: Laryngoscopy and tracheal intubation are noxious stimuli that evoke transient but marked sympathetic response manifesting as an increase in the heart rate, blood pressure, intraocular and intracranial pressure. These changes are seen maximum immediately after intubation and last for 5 to 10 minutes.1 Topical or intravenous (I.V.) lidocaine, opioids, inhaled anesthetics, vasodilators, calcium channel blockers or adrenergic blockers have been used successfully for decreasing the hemodynamic response to laryngoscopy. AIM AND OBJECTIVES: This study was done to compare the various doses of IV Esmolol in attenuating the haemodynamic stress response to laryngoscopy and endotracheal intubation. MATERIALS AND METHODS: 90 ASA I and II patients undergoing elective surgical procedure under general anaesthesia with endotracheal intubation were included in our present study. Patients belonging to age group 22-53 years of both the sexes were included. It is prospective double blind randomized study. The study was approved by the Ethical Committee and was randomly grouped into three groups. Group A (Esmolol 5 mg/kg) 20 patients were given Esmolol 0.5 mg/kg IV 2 minutes before the intubation. Group B (Esmolol 1.0 mg/kg)–20 Patients were given Esmolol 1 mg/kg IV 2 minutes before intubation. Group C (Esmolol 1.5 mg/kg) 20 patients were given Esmolol 1.5 mg/kg IV 2 minutes before intubation. STATISTICAL ANALYSIS: Heart rate, systolic Blood pressure, Diastolic pressure and mean arterial pressure were recorded using MS Excel software and analyzed using STATA software for determining the statistical significance. ANOVA test was used to determine the significance among three groups. Student’s ‘t’ test was used to compare the three groups in mean values of various parameters. The P value taken for signification is <0.05. RESULTS: The dose of Esmolol 1.5 mg/kg (Group C) to be more effective in attenuating the haemodynamic responses during laryngoscopy and ET intubation with no major adverse effects when compared to 0.5 and 1.0 mg/kg. CONCLUSION: On taking into consideration the criteria which we chose to study the haemodynamic changes expected, we found that the dose of Esmolol 1.5 mg/kg (Group C) to be effective in attenuating the haemodynamic responses during laryngoscopy and endotracheal intubation with no major adverse effects of Esmolol.
Authors and Affiliations
Dr. Pawan Kumar Dutta
Keywords
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- EP ID EP377291
- DOI 10.9790/0853-1707050912.
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