A COMPARATIVE STUDY OF DEXMEDETOMIDINE VS ESMOLOL FOR ATTENUATION OF STRESS RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION

Abstract

 Direct laryngoscopy and endotracheal intubation induce a transient circulatory reflex response characterized by tachycardia, hypertension and arrhythmias. This pressor response is not significant in healthy individuals but can be lethal in patients with cardiovascular or intracranial diseases.

Aims: To compare the efficacy of intravenous Dexmedetomidine and Esmolol in attenuating hemodynamic response to laryngoscopy and intubation in patients undergoing elective surgeries under general anesthesia.

Methods: This was a prospective, randomized study conducted on 52 patients aged between 18-60 years, with Mallampatti grade I or II. The subjects were divided into two equal groups, E & D which received Inj. Esmolol (1.0 mg/kg) in 10 ml normal saline two minutes before intubation and Inj. Dexmedetomidine (1 µg/kg) in 10 ml normal saline over ten minutes before intubation respectively. Hemodynamic parameters were recorded before and during intubation and at 0, 1, 3 and 5 minutes after intubation. The values of both the groups were compared and expressed as Mean ± SD. Statistical analysis was done using student’s t-test.

Results: There was a fall in the mean arterial pressure and heart rate in both the groups but the fall in hemodynamic parameters exacerbated due to pressor response was better noted with study drug Dexmedetomidine than Esmolol.

Conclusion: The pressor response to tracheal manipulation was significantly attenuated (p < 0.05) in both the groups but dexmedetomidine was more efficacious in blunting the pressor response