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ORIGINAL ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 2  |  Page : 67-73

Hemodynamic changes with intravenous dexmedetomidine and intravenous esmolol for attenuation of sympathomimetic response to laryngoscopy and tracheal intubation in neurosurgical patients: A comparative study


Department of Anaesthesia, JNMC and AVBRH, Wardha, Maharashtra, India

Correspondence Address:
Dr. Jayashree Sen
Department of Anaesthesia, JNMC and AVBRH, Sawangi, Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_65_19

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Background: Dexmedetomidine a highly selective α2-adrenoreceptor agonist and esmolol an ultra-short-acting β1-cardioselective adrenergic receptor blocker appear to be quite suitable to control the detrimental effects of laryngeal and tracheal stimulation. The study was conducted to compare the efficacy and safety of dexmedetomidine and esmolol for attenuation of hemodynamic responses to laryngoscopy and intubation in patients of elective neurosurgical procedures under general anesthesia. Materials and Methods: Sixty patients of age 20–60 years, the American Society of Anesthesiologists I and II posted for neurosurgical procedures, randomized into two groups of 30 each to receive dexmedetomidine (Group D): 1 μg/kg and esmolol (Group E): 1.5 mg/kg, both diluted to a total volume of 20 mL with 0.9% saline, infused intravenous over a period of 10 min, before 3 min of induction. Changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), rate pressure product (RPP), any side effects associated with the drugs during the study, i.e., 20 min of intubation, were observed and statistically analyzed. Result: There was no statistically significant difference (P = 0.195) in mean HR between Groups D and E during intubation but from the 1st min after intubation (T1) (0.0001) till 20th min (T20) (0.0041) a statistically significant difference in mean HR, mean SBP (P = 0.0001), mean DBP (P < 0.05), mean arterial pressure (P < 0.05), and mean RPP (P = 0.0001) was observed. Conclusion: Infusion of dexmedetomidine was better as compared to esmolol hydrochloride in attenuation of hemodynamic response to laryngoscopy and tracheal intubation.


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