OUTCOME OF DIFFERENT DOSES OF LABETALOL FOR CONTROLLING HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND TRACHEAL INTUBATION IN HYPERTENSIVE PATIENTS

Dr. Sheikh Rukun Uddin Ahmed*

ABSTRACT

Background: Now-a-days, labetalol is used for controlling hemodynamic responses to laryngoscopy and tracheal intubation in hypertensive patients. Objective: In this study our main goal is to evaluate the outcome of different doses of labetalol for controlling hemodynamic responses to laryngoscopy and tracheal intubation in hypertensive patients. Method: This a prospective, randomized, placebo controlled, double-blinded trial is conducted in tertiary medical college and hospital from January 2019 to December 2020. Where a total of 150 patients, ASA physical status I and II, aged 18–60 years, undergoing elective surgical procedures, requiring general anesthesia and orotracheal intubation were included in the study. Where in Group L1 – Syringe contained Labetalol (0.15 mg/kg diluted with 0.9% saline to 5 ml), Group L2 – Syringe contained Labetalol (0.3 mg/kg diluted with 0.9% saline to 5 ml) and Group C – Syringe contained 5 ml of 0.9% saline. Results: During the study, majority were belong to 41-50 years age group, 40% and 61.20% were female. Besides that, there was statistically significant difference in heart rate throughout study time between the L1 and control group (P < 0.001), and L2 and control group (P < 0.001). in addition, There was no significant difference in DBP between L1 and L2 at intubation and 1 min post-intubation. However, there was statistically significant difference in DBP between L1 and L2 group at 3 min, 5 min and 10 min post intubation (P < 0.001). Rate pressure product was significantly less at the time of intubation in the L1 and L2 group (P < 0.001) as compared to the control group. Conclusion: labetalol at both 0.15 mg/kg and 0.3 mg/kg iv dosages is efficacious in lowering hemodynamic responses to direct laryngoscopy and tracheal intubation in hypertensive patients in a dose-dependent manner. Bradycardia is more prevalent in patients taking labetalol at a dosage of 0.3 mg/kg.

Keywords: Laryngoscopy, tracheal intubation, labetalol.