Comparative evaluation of Intravenous Dexmedetomidine vs Esmolol for Attenuation of Hemodynamic Stress Responseduring Laryngoscopy and Endotracheal Intubation

Abstract

Background & Aims- Endotracheal intubation is essential for safe general anesthesia practice but it is associated with stress response due to sympathetic stimulation resulting in hypertension and tachycardia. So, to attenuate this stress response during laryngoscopy and endotracheal intubation, the efficacy of intravenous dexmedetomidine and esmolol were compared in this study. Materials And Methods- The study was carriedon total 210 ASA grade I or II patients of aged 18-60 years who were scheduled for elective laparoscopy surgery under general anesthesia. All the patients were randomly divided into the threegroups of 70 each. Incontrol group (group C)-intravenous (IV) 0.9% saline plain, dexmedetomidine group (group D)- 1 μg/kg dexmedetomidine and esmolol group (group E)- 1.5 mg/kg esmolol diluted with 0.9% saline in volume of 20 ml IV were infused over 10 minutes and after that induction of anaesthesia was done.Hemodynamic parameters were recorded at baseline, before intubation, during intubation, and then every 1 minute up to 10 minutes. Results- In group D, increase in heart rate and blood pressure after intubation at any time intervals was not statistically significant, whereas in group E, there was a statistically significant increase in blood pressure after intubation at 1, 2, and 3 minutes only and in heart rate up to 5 minutes. Conclusion- Dexmedetomidine is better alternative to esmolol for attenuating the stress response to laryngoscopy and intubation during general anaesthesia.