Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation with two different doses of labetalol in hypertensive patients

Abstract

The present study compared the efficacy of two different doses of labetalol, for attenuation of hemodynamic response to laryngoscopy and intubation in hypertensive patients. Patients and methods: 75 hypertensive patients, aged 18-60 years undergoing elective surgical procedures, require general anesthesia and orotracheal intubation. Patients were allocated to any of the three groups (25 each), Group C (control) 5 ml 0.9% saline. Group L1 (labetalol) 0.15 mg/kg diluted with 0.9% saline to 5 ml. Group L2 (labetalol) 0.3 mg/kg diluted with 0.9% saline to 5 ml. In the control group 5 ml of 0.9% saline was given i.v. 5 min prior to intubation. In the L1 group 0.15 mg/kg of labetalol was given i.v. 5 min prior to intubation. In the L2 group 0.3 mg/ kg of labetalol was given i.v. 5 min prior to intubation. All the patients were subjected to the same standard anesthetic technique. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded prior to induction, at time of intubation and 1, 3, 5, and 10 min after intubation. Mean arterial pressure (MAP) and rate pressure product (RPP) were calculated. Results: Compared to placebo both the doses of labetalol (0.15 mg/kg) and (0.3 mg/kg) significantly attenuated the rise in heart rate, systolic blood pressure, and RPP during laryngoscopy and intubation. However, the difference was not statistically significant between both doses of labetalol at intubation, 1 min, 3 min and 10 min post-intubation. Conclusion: Both doses of labetalol (0.15 mg/kg and 0.3 mg/kg) attenuate hemodynamic response to laryngoscopy and intubation in dose dependent manner.

Premedication with gabapentin for laryngoscopy: a double-blind randomized control trial in hypertensive patients

“…It is, therefore, of prime importance to prevent the likely hemodynamic changes following tracheal intubation in hypertensive patients. 15 Attenuation of hemodynamic stress response to L&I in normotensive patients has been documented in various studies in the literature. A study by Serhat Koc et al compared 400 mg and 800 mg of gabapentin, and they reported that the lower dose was ineffective in preventing pressor response after tracheal intubation.…”

To evaluate the efficacy between 0.15mg/Kg and 0.25mg/Kg of iv labetalol in the suppression of haemodynamic response to extubation

“…9,10 Labetalol is a moderately lipid soluble drug with the peak effect on Intravenous administration is 5 -15 minutes. 11 In the study conducted by Kumar R et al 12 between 0.15mg/kg and 0.3mg/kg doses of Labetalol on suppression of pressor responses to laryngoscopy and endotracheal intubation, the authors found out that both the doses of Labetalol were efficient in supressing the haemodynamic stress response to laryngoscopy and intubation in a dose dependent manner.…”

Blunting Stress Response During Intubation in Hypertensive Patients; A Comparison Between Lidocaine and Magnesium Sulphate

“…It can also lead to cerebrovascular accidents in hypertensive patients with cerebrovascular disease. 12 Various drug including β-blockers such as Labetalol, 13 and Esmolol, 14 Opioids, Lidocaine, 15,16 Nitroglycerine, alpha adrenergic agonists such as Clonidine, 17 and dexmedetomidine, 17 calcium channel blockers such as Diltiazem, 18 and have been used for obtunding the stress response. Lidocaine, whether given intravenously or through an endotracheal tube, successfully prevents the rise in blood pressure but fails to prevent the rise in heart rate.…”