Abstract
Direct laryngoscopy and endotracheal intubation is associated with reflex cardiovascular responses mediated by the sympathetic nervous system. Various drugs have been used to attenuate these haemodynamic responses. Esmolol, an ultra short acting β blocker with rapid onset of action is suitable for attenuation of hemodynamic response to laryngoscopy and intubation. A prospective observational study was done with 3 groups of 30 patients each presenting for elective surgery. For attenuation of stress response to intubation, Group A received no drug, Group B received intravenous esmolol 1mg/kg, 1 minute before induction and Group C received intravenous esmolol 2mg/kg 1minute before induction. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product were recorded before induction,1minute, 3minute, 5minute, 7minute and 10 minute intervals after induction. It was found that there is a significant hemodynamic response to laryngoscopy and intubation in those who did not receive any drug for hemodynamic response attenuation. Esmolol in a bolus dose of 1mg/kg(B) and 2mg/kg(C) given 1minute before induction effectively attenuated the hemodynamic response to laryngoscopy and intubation. Group C was often associated with systolic blood pressure lesser than the pre-induction values. Esmolol in a bolus dose of 1mg/kg given 1minute before induction is therefore the recommended dose for attenuation of hemodynamic response to laryngoscopy and intubation.
Keywords: Laryngoscopy, Stress response, Esmolol.
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DOI: https://dx.doi.org/10.18535/jmscr/v5i5.144
