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A Comparative Study of Dexmedetomidine HCL and Esmolol HCL for Attenuating Pressor Response to Laryngoscopy and Oral Endotracheal Intubation

Anupama Kumari, Resident, Department of Anesthesia, Gujarat Cancer & Research Institute (GCRI), Civil Hospital, Ahmedabad, Gujarat 380016, India. , Patel Leena1 , Kumari Anupama2 , Agarwal Misha3 , Jayshree Thakkar4 , Rathva Chirag5

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Indian Journal of Anesthesia and Analgesia 5(9):p 1511-1516, September 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.13

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Abstract

Introduction: Laryngoscopy and intubation increases sympathetic activity resulting in tachycardia and hypertension which may cause myocardial ischemia, cardiac arrhythmias and cerebrovascular hemorrhage. We compared the efficacy of intravenous esmolol and dexmedetomidine to attenuate the pressor response to laryngoscopy and intubation.

Design: Randomised controlled trial.

Method: Seventy-five patients of ASA I and ASA II undergoing general anesthesia with oral intubation for elective surgery were allocated into three groups.Group C: Control group. Group E: intravenous esmolol 2mg/kg three minutes before laryngoscopy. Group D: Intravenous dexmedetomidine 1g/kg in 100ml infusion over ten minutes before laryngoscopy. Heart rate, systolic, diastolic and mean arterial pressures were recorded before drug administration, after drug administration, after induction of standard anesthesia, immediately after intubation, every 2 minutes till 10 minutes. Incidence of bradycardia and hypotension were noted.

Statistical Analysis used: IBM SPSS version.

Results: Mean HR immediately after intubation for group C was (104.57±8.2) whereas it was (83±4.53, 92.6±4.70) for group D and group E with p value of (0.003,0.002) when compared to control group. While comparing group D and E, p value was 0.0001. MAP immediately after intubation for group C was (109±5.9) whereas it was (98±3.4, 100.2±5.2) for group D and E with p value (0.0001, 0.002) when compared to control group. While comparing group D and E, p value was 0.006.

Conclusion: Dexmedetomidine and esmolol both attenuated the pressor response to laryngoscopy and intubation but it was better controlled with dexmedetomidine.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.13

Keywords

Pressor Response; Laryngoscopy; Esmolol; Dexmedetomidine.

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