“Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation - comparison of fentanyl, esmolol and metoprolol” in normotensive individuals
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2017, Vol 4, Issue 1
Abstract
Introduction: Direct laryngoscopy and endotracheal intubation is an intrinsic component of general anaesthetic technique. It is a powerful stimulus which may evoke a plethora of sympathoadrenal stress responses. Various methods have been tried to attenuate the hemodynamic response. The objective of this study is to compare the effects of fentanyl, metoprolol, esmolol on the hemodynamic response during laryngoscopy and endotracheal intubation in normotensive individuals. Methods: These 120 patients were randomly divided into 4 groups (F, M, E and S) to receive either the test drug or the control. GROUP F received fentanyl 1µg kg-1, GROUP M received Metoprolol 25µg kg-1, GROUP E received Esmolol 100µg kg-1 and GROUP S received saline to determine which drug best attenuated the pressor response to laryngoscopy and endotracheal intubation. Baseline heart rate and blood pressure were recorded during laryngoscopy, endotracheal intubation and up to 10 minutes prior to surgery. Results: Esmolol effectively reduced the increase in heart rate when given half a minute prior to laryngoscopy and endotracheal intubation. Fentanyl effectively reduced the increase in mean arterial pressure only after 3 minutes of laryngoscopy and endotracheal intubation (LETI). Metoprolol 25µg kg-1 produced a gradual reduction in heart rate and mean arterial pressure only after minutes of laryngoscopy making it ineffective for the same purpose. Conclusion: We conclude that esmolol and fentanyl can be safely used to attenuate the pressor response during laryngoscopy and intubation. Fentanyl may be used to attenuate pressor response in patient whom β-blockers are contraindicated like patients with second and third degree heart block, congestive heart failure, acute bronchospasm, and other hemodynamic instability.
Authors and Affiliations
Pratheeba N, Remadevi R, Ravindra Bhat R, Sanjeev Kumar B
Keywords
Related Articles
- EP ID EP311475
- DOI 10.18231/2394-4994.2017.0019
- Views 95
- Downloads 0
Comparison of intraperitoneal bupivacaine alone or with dexmedetomidine or tramadol for post-operative analgesia following laparoscopic cholecystectomy
Introduction: This study was conducted to evaluate the effect of Intraperitoneal Bupivacaine alone or with dexmedetomidine or tramadol for relief of pain after laparoscopic cholecystectomy. Material and Methods: The pati...
Etomidate versus Propofol as induction agent in patients undergoing Endoscopic Retrograde Cholangiopancreaticogram (ERCP)
Background: Endoscopic retrograde pancreaticogram (ERCP) requires patient to be sedated and pain free in prone position. Propofol sedation may cause cardiorespiratory depression. Etomidate is a good alternative with stab...
A prospective randomized study comparing 0.5% isobaric solutions of levobupivacaine and ropivacaine with fentanyl as an adjuvant for subarachnoid block in patients undergoing elective lower limb surgery
In the present study we compared levobupivacaine with ropivacaine in order to determine the suitability of each drug for spinal anaesthesia. Aim: To compare levobupivacaine with ropivacaine with respect to onset, duratio...
Comparison of two supraglottic airways - I-gel and Proseal laryngeal mask airway for ease of insertion and hemodynamic stability
Introduction and Aims: Supraglottic airway devices are safe and efficient in airway management. I-gelTM and ProsealTM laryngeal mask airway are supraglottic airway devices which are used to secure and maintain airway dur...
Low dose oral clonidine as premedication in laparoscopic surgery
Introduction: Clonidine modulates the cardiovascular changes caused by pneumoperitoneum in laparoscopic procedures. This study aims at comparing the haemodynamic variation, requirement of intraoperative opiods (fentanyl)...