AN OBSERVATIONAL STUDY OF EFFECT OF ESMOLOL ON ATTENUATION OF PRESSOR RESPONSE TO LARYNGOSCOPY AND INTUBATION

Dr. Prakash Dhumal, *Dr. Saee Gosavi and Dr. Deviprasad Shivade

ABSTRACT

Introduction: Endotracheal intubation and laryngoscopy provides an intense noxious stimulus via vagal and glossopharyngeal afferents that result in a reflex autonomic activation, which is usually manifested as hypertension and tachycardia. This reflex is termed as pressor response. Esmolol possesses several properties to attenuate this response. Primary objective- to study the effect of 0.4mg/kg esmolol on attenuation of pressor response Secondary objective- assess hemodynamic changes during laryngoscopy and intubation. Methods: After institutional review, board approval and written informed consent, 62 patients with ASA physical status I-II aged 18-50 years to undergo elective surgery under general anaesthesia were studied. Patients with known allergies, hypertension ,diabetes, heart blocks, ischemic heart disease, brain disease and baseline HR<60 and SBP<100 were excluded. Patients were randomly divided into two groups, group E received injection Esmolol 0.4mg/kg and group C received normal saline 3min before intubation. All hemodynamic changes were monitored at baseline, before induction, before intubation and after intubation. Observation and results: The differences in parameters was statistically significant. The rise in heart rate 30sec after intubation was more in group C than group E. The blood pressure, mean arterial pressure and rate pressure product were more in group C than group E after intubation. No significant ECG changes were seen in both groups. Conclusions: This study confirmed that there is significant increase in hemodynamic variables on laryngoscopy and intubation and concludes that esmolol in low dose attenuates pressor response to some extent.

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