Background: Cardiovascular complications are one of the most common causes of anesthesiarelated morbidity and mortality.The present work was undertaken to compare the effect of lignocaine (Xylocard) with esmolol on blunting the hemodynamic responses to endotracheal intubation.

Methods: Laryngoscopy and intubation was done within 15 to 20 seconds.In group I: Inj. Lignocaine (Xylocard) i.v. was administered 3 minutes before laryngoscopy and intubation.In group II: Inj. Esmolol i.v. was administered 3 minutes before laryngoscopy and intubation. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were measured before induction of general anesthesia (baseline), 1, 3, and 5 min after tracheal intubation.

Results: The heart rate response between lignocaine (Xylocard) and esmolol was very significant at all times starting from 1 to 10 minutes (p  0.05) with esmolol showing a favorable response towards attenuation of heart rate. In systolic blood pressure, Esmolol group showed a better attenuation compared to lignocaine group (Xylocard) until 3 minutes postlaryngoscopy. Attenuation of diastolic blood pressure was significant with esmolol than with lignocaine (Xylocard) group until 3 minutes (p<0.05). In mean arterial pressure, Esmolol caused significant attenuation of pressor response (p<0.05) at 1 minute and 3 minute postlaryngoscopy.

Conclusion: Esmolol is more efficient than lignocaine (Xylocard) in attenuating the sympathetic responses to laryngoscopy and intubation.Esmolol at a bolus dose of 1.5 mg/kg i.v. administered 3 minutes before laryngoscopy appears to be very effective and should be viewed as potential treatment strategy for attenuating hemodynamic changes during induction of anesthesia.