Comparison of Esmolol and Dexamedetomidine Effects on Symphtomimmetic Response of Elective Surgical Patients After Laryngoscopy and Intubation.
Esmolol and Dexamedetomidine Effects on Symphtomimmetic Response
Background: In anaesthetized patients laryngoscopy and tracheal intubation both are noxious stimuli’s causes hypertension and tachycardia that are marked sympathetic response which are unwanted, particularly in patients with cardiovascular or neurosurgical diseases undergoing anesthesia. Dexmedetomidine has unique pharmacokinetics making it difficult to compare with other routinely used drugs such as esmolol and lignocaine. Subjects and Methods: Study population (n=90) of the current study was randomly divided into three groups. Group I (control), group II (dexmedetomidine) and group III (esmolol) respectively received 20 ml 0.9% saline, 1 g/kg of dexmedetomidine and 1.5 g/kg of esmolol. Base line, 5 minutes after the study drug administration, induction baseline and 1, 3, 5, 7, and 10 minutes after orotracheal intubation heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were recorded. Results: There was no significant difference in mean heart rate (p>0.05) at baseline between all three groups. A significant increase in mean heart rate of group I (4.72 %) whereas a significant decrease mean heart rate of group II (20.71%) and group III (4.32%) were recorded. It is evident from figure 1 that there was a significant decrease in SBP, DBP and MAP group II and group III compare to group I after the infusion and just before intubation. Mean SBP values increased in all the three groups at 1 min after intubation. The values of SBP in Group II were significantly lower than that of Group I and Group III (p < 0.01). Conclusion: Findings of the current study suggest that both dexmedetomidine and esmolol were found effective in improving symphtomimmetic response to laryngoscopy and inintubation in normotensive patients. However, dexmedetomidine showed better attenuation of haemodynamic response compare to esmolol.