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Comparison of Dexmedetomidine Versus Esmolol to Decrease the Stressor Responses during Tracheal Intubation and Immediately Thereafter

Pradeep R.* , Pradeep R.* , Chandrashekar Tolla**

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Indian Journal of Anesthesia and Analgesia 4(1):p 95-99, January - March 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4116.15

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Abstract

 Context: Endo­tracheal intubation following laryngoscopy may cause sympathetic stimulation by releasing catecholamines and may result in complications like hypertension, tachycardia, cardiac arrhythmias, cerebrovascular accidents, which can be detrimental to the patient’s life. Many drugs and techniques are being tried to reduce the stressor responses to intubation over years, and Dexmedetomidine and esmolol are the newer drugs. Aims: This study was aimed at comparing dexmedetomidine versus esmolol in attenuating hemodynamic responses during and immediately after tracheal intubation. Settings and Design: This study was a randomised prospective double­blind controlled study. Subjects and Methods: Ninety patients posted for surgery under general anesthesia were divided into three groups, D and E and C with thirty patients in each group. Group­D patients received the first study drug dexmedetomidine 0.5 µg/kg, Group­E patients received the second study drug esmolol 1 mg/kg and Group­C patients received 0.9% 20ml saline as intravenous over 5 minutes before anaesthesia induction. The subject’s Systolic blood pressure, diastolic and mean arterial blood pressures with heart rate were measured at 1st, 3rd 5th, 7th, 10th minute post­ intubation. Statistical Analysis: The statistical methods employed were descriptive and inferential methods for the analysis of the obtained data. Results: A statistically significant differences were seen in the period between endotracheal intubation and at 3 minute post intubation in Group D. The heart rate, systolic, diastolic pressure and mean arterial pressures showed statistically significantly lesser increase in dexmedetomidine group (P<0.05) than compared to other two groups at immediate post intubation and till 3minutes thereafter. Conclusions: Dexmedetomidine is more efficient than esmolol in reducing the stressor responses to tracheal intubation and immediately (< 3minutes) thereafter.

Keywords:Dexmedetomidine; Esmolol; Hemodynamics; Intubation; Laryngoscopy.

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DOI: DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4116.15

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