Attenuation of hemodynamic response to laryngoscopy and intubation using intravenous fentanyl and esmolol: A study

Abstract

Background: The present study was designed to compare the effect of intravenous fentanyl and esmolol for the attenuation of hemodynamic responses to laryngoscopy and intubation. Materials and Methods: Ninety patients undergoing elective surgical procedures were allocated into three groups viz., Group I (control): Identical volume of normal saline intravenously (IV) 3 min before induction; Group II (fentanyl): Injection fentanyl 2 mcg/kg IV 3 min before induction; Group III (esmolol): Injection esmolol 0.2 mg/kg i.v 3 min before induction. The heart rate and arterial blood pressure changes were monitored at the following time intervals: Before intubation, at intubation, and after intubation at different time intervals. The results were tabulated and statistically analysed and P ≤ 0.05 was considered significant. Results: Maximum rise in systolic blood pressure was observed at the post-intubation first minute, i.e., 22% (163.60 ± 16.25); 15% (144.13 ± 24.72); and15% (153.80 ± 24.75) in the Group I, II, and III from the baseline, respectively. Changes in the systolic blood pressure (SBP) was found to be minimum with fentanyl and esmolol groups when compared to the control group (P < 0.001). The diastolic blood pressure and mean arterial pressure changes was significant between fentanyl and esmolol groups with the control but not between esmolol and fentanyl. Group II showed better control of heart rate during laryngoscopy and intubation at the first min after intubation compared to other groups (P < 0.05). Conclusion: Fentanyl 2 μg/kg bolus or esmolol 0.2 mg/kg bolus 3 min before induction significantly attenuates the hemodynamic response to laryngoscopy and intubation better than control group.