A study of the efficacy of intravenous bolus dose of Esmolol hydrochloride for attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation during general anaesthesia

Dr. Bikram Mohan; Dr. (Prof) Rajesh Khanna; Dr. (Prof) Usha Suwalka

Volume : VIII, Issue : V, May - 2019

A study of the efficacy of intravenous bolus dose of Esmolol hydrochloride for attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation during general anaesthesia

Dr. Bikram Mohan, Dr. Prof Rajesh Khanna, Dr. Prof Usha Suwalka

Abstract :

Background: Laryngoscopy and tracheal intubation is invariably associated with a reflex sympathetic pressor response resulting in elevated heart rate and blood pressures. This may prove detrimental in high-risk patients. Objective of this study was to compare the effects of 1mg/kg i.v bolus dose of Esmolol in attenuation of this response. Methods: 70 ASA I - II status normotensive patients scheduled for elective surgical procedures were selected randomly and divided into two groups of 35 each. After premedication just before induction the study drug was given intravenous in 15-20 seconds. Thereafter, inducing the patient with Propofol and Succinylcholine following pre-oxygenation; mask ventilation started for 4 minutes and then act of laryngoscopy and endotracheal intubation were performed in a smoothest possible manner and as quickly as possible. The anaesthesia was maintained with 50% of oxygen in Nitrous oxide, Isoflurane and Vecuronium omide. The heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure and rate pressure product along with arrhythmia if any, recorded just before induction, at the time of intubation and 1, 3 and 5 minutes after intubation in both the group of patients. The result obtained was then studied and analyzed with statistical reference they were compared. Results: After intubation incidence of tachycardia was significantly greater in control group than in Esmolol group. Rise in SBP, DBP, RPP were also statistically significant in control group than in esmolol group. Conclusion: Attenuation of pressor response is seen with Esmolol. Esmolol 1mg/kg i.v. bolus provides a consistent, reliable and effective attenuation.