Subhadeep Chakraborty, Amalendu Bikas Chatterjee, Swarup Dutta
BACKGROUND Laryngoscopy and endotracheal intubation produces distinct but transient increase in cardiac workload. In this study, a comparison is made between dexmedetomidine, esmolol and control in their effect in attenuation of pressure response during laryngoscopy and endotracheal intubation. MATERIALS AND METHODS With written consent, we studied hundred and twenty-five (125) adult patients of American Society of Anesthesiologists physical status I and II, aged between 30 to 60 years, of either sex, undergoing elective upper abdominal surgeries. The patients were randomly allocated into three groups: 1) 42 patients in group (D) received Dexmedetomidine (1 μg/kg), 2) 42 patients in group (C) received normal saline 15 ml, and 3) 41 patients in group (E) received Esmolol (2 mg/kg). All patients received the drugs intravenously over 10 minutes and 3 min before induction of general anaesthesia. Premedication, induction and intubation were similar. Heart rate (HR), systemic arterial pressures were recorded at baseline, after study drug infusion, after induction, immediately and 3, 5, 7, 10 min after intubation. Study Design- Prospective, randomized, double blind, controlled study. Statistical Analysis- Analysis of variance and t-test as appropriate. RESULTS The heart rate, systolic arterial pressures and rate-pressure product immediately after intubation and thereafter were significantly lower in Group D (P<0.001) when compared to Group E and Group C. Group E had the same post-intubation parameters reliably (P<0.001) lower than Group C. CONCLUSION Dexmedetomidine and esmolol were both effective in attenuating the haemodynamic response to intubation, but dexmedetomidine was more effective than esmolol in lowering the haemodynamic response.
