An observational study to compare the efficacy of intravenous dexmedetomidine versus intravenous esmolol for attenuation of pressor response during laryngoscopy and endotracheal intubation

Abstract

Laryngoscopy and endotracheal intubation during general anaesthesia is an invasive stimulus associated with release of circulating catecholamine leading to hemodynamic and cardiovascular responses resulting in tachycardia, hypertension and arrhythmias. Many prophylactic drugs have been used to decrease cardiovascular response to laryngoscopy & intubation. Aim of this study is to compare effectiveness of Dexmedetomidine 1μg/kg and Esmolol 1 mg/kg intravenously in attenuating cardiovascular response during laryngoscopy and intubation during general anaesthesia.This randomised double blinded prospective study was conducted on 50 patients, of either gender between age group 18-60 years and American Society of Anaesthesiology (ASA) classification I & II, undergoing various surgeries under General anaesthesia requiring intubation. Patients were randomly divided into 2 groups of 25 patients each. Group D patients received intravenously Inj. Dexmedetomidine 1 mcg/kg as an infusion in 100ml Normal Saline over 20 minutes before induction of general anaesthesia. Group E patients received intravenously Inj. Esmolol 1 mg/kg diluted with normal saline to volume of 10ml given just before induction of general anaesthesia.Hemodynamic parameters such as Heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at baseline, after study drug administration, after induction, at laryngoscopy and intubation and 1, 3, 5 and 7 min after Endotracheal intubation.: Comparison of two groups reveals that dexmedetomidine shows less rise in heart rate (P-0.0003) and mean arterial pressure (P-0.0106) at the laryngoscopy and intubation. It also shows less rise in systolic and diastolic blood pressure after induction and after intubation (P< 0.05) than Esmolol. This study suggests that Dexmedetomidine 1µg/kg was more effective in attenuating the stress response to laryngoscopy and intubation as compared to Esmolol 1mg/kg.