A comparative study of efficacy of esmolol and fentanyl for pressure attenuation during laryngoscopy and endotracheal intubation

Abstract

Objective:To compare the effectiveness of single bolus dose of esmolol or fentanyl in attenuating the hemodynamic responses during laryngoscopy and endotracheal intubation.Methods:Ninety adult ASA I and ASA II patients were included in the study who underwent elective surgical procedures. Patients were divided into three groups. Group C (control) receiving 10 ml normal saline, group E (esmolol) receiving bolus dose of esmolol 2 mg/kg and group F (fentanyl) receiving bolus dose of fentanyl 2 µg/kg intravenously slowly. Study drug was injected 3 min before induction of anesthesia. Heart rate, systemic arterial pressure and ECG were recorded as baseline and after administration of study drug at intubation and 15 min thereafter.Results:Reading of heart rate, blood pressure and rate pressure product were compared with baseline and among each group. The rise in heart rate was minimal in esmolol group and was highly significant. Also the rate pressure product at the time of intubation was minimal and was statistically significant rate 15 min thereafter in group E.Conclusion:Esmolol 2 mg/kg as a bolus done proved to be effective in attenuating rises in heart rate following laryngoscopy and intubation while the rise in blood pressure was suppressed but not abolished by bolus dose of esmolol.

Comparison of effect of Labetalol and fentanyl with only fentanyl for attenuating pressure responses to intubation and skull pin insertion in neurosurgery

“…Fentanyl suppresses the haemodynamic response by increasing the depth of anaesthesia and decreasing the sympathetic discharge. 26 Similar to our study Ayse Mizrak and et al found neither fentanyl nor local infilteration of lidocaine 2% scalp block alone could effectively suppress the MAP 9 but, the combined use of both the drugs was able to suppress the MAP after pin fixation.…”

Comparison of Dexmedetomidine with Fentanyl in Attenuation of Pressor Response during Laryngoscopy and Intubation

“…However increased in heart rate was more in Group F as compare to Group D.This increase was highly significant (p<0.001). These observations are comparable to those by Martina Ahoet al 8 , Sukhminderjit Singh Bajwa et al 32 , N. Turgut et a 22 . However Sukhminderjit Singh Bajwaet al 32 used Dexmedetomidine in dose of 1 µg/kg and N. Turgut et al 22 used Fentanyl in dose of 1 µg/kg.…”

Attenuation of stress response to laryngoscopy and intubation: sublingual nitroglycerin spray vs intravenous fentanyl and sublingual nitroglycerin spray

“…Our results coincide with a study conducted by Gupta and Tank et al, Parida S et al who used Fentanyl 2 μg/kg intravenously slowly 3 min before induction of anesthesia to attenuate the pressor response to laryngoscopy and intubation. 11,20 Withington PS et al found that the heart rate was consistently higher but not statistically significant after NTG infusion during Fentanyl, thiopentone, pancuronium anaesthesia in coronary artery bypass graft surgery. 21 Ebert JP et al reported Fentanyl intravenously decreased heart rate below baseline and maintained it there.…”

“…9 Fentanyl citrate, an opioid is a phenylpiperidine of the 4-aminopiperidine series structurally related to pethidine and controls both heart rate and blood pressure responses. 10,11 However, Fentanyl can produce complex respiratory depression and truncal rigidity at higher doses. Administration of NTG alone during preintubation may not be sufficient to completely mediate hemodynamic response due to the tendency of Nitroglycerine to produce tachycardia.…”