Comparison of Esmolol and Lidocaine for Blunting of Stress Response during Laryngoscopy and Endotracheal Intubation
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 8
Abstract
Background: Direct laryngoscopy and endotracheal intubation lead to stimulation of strong cardiovascular responses. Various attempts have been made to attenuate these responses. The aim of this study was to compare the efficacy and safety of intravenous esmolol and lidocaine in suppressing the cardiovascular response to laryngoscopy and tracheal intubation in normotensive patients undergoing general anesthesia. Materials and Methods: This randomized controlled study was conducted in 90 normotensive patients of age group 18–60 years and American Society of Anaesthesiologists (ASA) physical Status I or II undergoing elective surgeries. The patients were randomly divided into three groups of 30 patients each (n = 30) - control, (C) lignocaine (L), and esmolol (E). Group - “C” received 10 ml normal saline, Group -“L” received 2 mg/kg diluted up to 10 ml preservative-free lidocaine, and Group -“E” received 2 mg/kg esmolol IV diluted up to 10 ml, 2 min before intubation. Induction was done with thiopentone 5 mg/kg, fentanyl 2 μg/kg, and vecuronium 0.1 mg/kg uniformly as per protocol. Thereafter, changes in heart rate (HR), systolic blood pressure (SBP), diastolic BP (DBP), and mean arterial BP (MAP), were measured before induction of general anesthesia (baseline), 1, 3, and 5 min after tracheal intubation. Patients were also observed for any complications. Statistical analysis was performed by ANOVA and post hoc tukey test. Results: Group C had statistically highly significant (P ≤ 0.0001) value of HR, SBP, DBP, and MAP at all time interval after intubation when compared to Group L and Group E, and, Group L had statistically significant (P ≤ 0.05) higher values of hemodynamic variables at all time interval when compared to Group E. Conclusions: Both esmolol and lignocaine are effective in attenuating the stress response due to laryngoscopy and intubation, but esmolol maintains hemodynamic variables more stable.
Authors and Affiliations
Parul Jain, Amisha Vats
Keywords
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