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A Comparative Study of the Effects of Intravenous Esmolol and Sublingual Nitroglycerine Spray on Hemodynamic Response Following Tracheal Extubation

Mahamad Javeedulla Baig , Harsha Prakash BG , Mahamad Javeedulla Baig , Megha Rungta , Manjunath SM , Satish Kumar MN , Ramachandraiah R.

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Indian Journal of Anesthesia and Analgesia 7(2):p 473-481, Mar-Apr 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.5

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Harsha Prakash B G, Mahamad Javeedulla Baig, Megha Rungta, et al. A Comparative Study of the Effects of Intravenous Esmolol and Sublingual Nitroglycerine Spray on Hemodynamic Response Following Tracheal Extubation. Indian J Anesth Analg. 2020;
7(2 ):473–481.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: Recovery from general anesthesia and tracheal extubation is associated with increased hemodynamic response due to reflex sympathoadrenal activity and can be dangerous in susceptible patients. Many pharmacological methods were used to attenuate hemodynamic response but none were ideal. Aims: The aim of this study was to compare the effects of intravenous Esmolol and sublingual Nitroglycerine spray on hemodynamic response following tracheal extubation in patients undergoing general anesthesia for various surgeries. Methods: 60 patients of ASA 1 and 2 of either sex undergoing elective surgeries under general anesthesia were placed randomly in either Group A (n = 30) or Group B (n = 30). Group A received intravenous Esmolol 1.5 mg/kg and Group B received Sublingual 0.8 mg NTG spray. Either of the study drug was administered after 1 minute of the reversal agents being given. Hemodynamic variables HR, SBP, DBP and MAP were monitored and noted during tracheal extubation. Results: Intravenous Esmolol group had better control over heart rate when compared to Sublingual NTG spray group during tracheal extubation. Sublingual NTG spray group had modest increase in heart rate (Mean of 122 bpm). With respect to Systolic, Diastolic and Mean arterial blood pressure both the groups were found to be statisticaly insignificant and had clinically significant control over hemodynamic response during tracheal extubation. Conclusion: Intravenously administered Esmolol in dose of 1.5 mg/kg attenuates tracheal extubation response by having better control on heart rate and blood pressure with minimal complications when compared to sublingual 0.8 mg NTG spray group.

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Harsha Prakash B G, Mahamad Javeedulla Baig, Megha Rungta, et al. A Comparative Study of the Effects of Intravenous Esmolol and Sublingual Nitroglycerine Spray on Hemodynamic Response Following Tracheal Extubation. Indian J Anesth Analg. 2020;
7(2 ):473–481.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.5

Keywords

Nitroglycerin (NTG); Esmolol; Tracheal Extubation; Hemodynamic response.

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