Prospective randomized study to compare between intravenous dexmedetomidine and esmolol for attenuation of hemodynamic response to endotracheal intubation

Abstract

Background:Esmolol has an established role in attenuation of hemodynamic response to laryngoscopy and endotracheal intubation. We studied the effect of dexmedetomidine compared to that of esmolol in this study.Aim:To study the role of dexmedetomidine in attenuation of hemodynamic response to laryngoscopy and oral endotracheal intubation compared to that of esmolol hydrochloride in patients posted for elective surgery under general anesthesia.Study Design:Prospective randomized study double-dummy blinding method.Materials and Methods:A total of 60 American Society of Anesthesiologists I patients, aged 18–60 years randomly divided into two groups; Group A patients received dexmedetomidine 1 mcg/kg diluted in 50 ml with normal saline and infused over 10 min before induction and also 20 ml of normal saline intravenous (IV) 2 min before endotracheal intubation. Group B patients received 50 ml IV infusion of normal saline over 10 min before induction and IV bolus of esmolol 0.5 mg/kg diluted in 20 ml with normal saline given 2 min before intubation. Standard induction technique followed. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded just before induction and after intubation at 1 min, 3 min, and 5 min after intubation.Statistical Analysis:Independent samples t-test and repeated measures of analysis of variance.Results:Dexmedetomidine group showed statistically significant reduction in all the study parameters at all study time intervals following intubation. While esmolol group showed significant attenuation of HR, SBP, and MAP following intubation but failed to produce significant reduction in DBP.Conclusion:Dexmedetomidine is more effective in attenuating the hemodynamic response to oral endotracheal intubation compared to that of esmolol hydrochloride.

Comparison of esmolol and dexmedetomidine for suppression of hemodynamic response to laryngoscopy and endotracheal intubation in adult patients undergoing elective general surgery: A prospective, randomized controlled double-blinded study

“…conducted a similar study in neurosurgical patients and found dexmedetomidine better. [ 21 ] Gupta and Vyas[ 22 ] and Selvaraj and Manoharan[ 23 ] also observed similar results.…”

Haemodynamic Responses to Laryngoscopy and Endotracheal Intubation After Intravenous Dexmedetomidine: A Comparison Between Two Doses

“…[14][15][16][17] Its effectiveness in obtunding the pressor response during intubation has also been compared with other drugs and placebos and found to be more effective than these drugs. [18][19][20][21][22][23][24][25] Dexmedetomidine has been used in different doses in infusion form with or without bolus doses. Some researchers found that Dexmedetomidine given in the dose of 0.25-0.5 µg/Kg body weight only decreased blood pressure while doses of 1-2 µg/Kg was associated with transient increase in blood pressure followed by hypotension and bradycardia with, maximum fall in heart occurred with the dose of 2 µg/Kg body weight.…”

“…and found that it is superior to these drugs in obtunding the hemodynamic changes during intubation. [18][19][20][21][22][23][24][25] Effects of different doses of dexmedetomidine on intubation response have also been studied. Dexmedetomidine in the doses of 0.5 µg/Kg body wt.…”

Effects of Intubation on heart rate: Xylocard and Esmolol

“…The present study was done to measure the cardiovascular response to laryngotracheal stimulation and to find a simple, safe and effective method for diminishing the cardiovascular reaction. [8] In our study we used IV lignocaine and IV esmolol to attenceate the response. Lignocaine was used in dose of 1.5 mg/kg body weight and Esmolol 500mcg/kg.…”