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Category: Volume 06 Issue 01 January 2018
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Title: Attenuation of Cardiovascular Responses to Tracheal Extubation: Esmolol versus Propofol

Authors: Dr Konda Sunil Kumar, Dr G. Laxminarsaiah

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.138

Abstract

The present study attenuation of cardiovascular responses to tracheal extubation: esmolol versus propofolwas a randomized study conducted to evaluate haemodynamic response to extubation with use of IV Propofol, IV Esmolol 2 minutes prior to extubation. After taking approval from institutional ethical committee and satisfying the inclusion and exclusion criteria; valid written informed consent was obtained from 60 adult patients were randomly allocated the two study groups. Patients were given following drugs two minutes prior to Extubation: Group E: patients received i.v. Esmolol 1.5 mg/kg and Group P patients received i.v. Propofol 0.5 mg/kg 2 minutes prior to extubation. Patients were given general anaesthesia as per protocol of our study. Haemodynamic parameters were monitored throughout the whole procedure, the study drug was given 2 minutes prior to Extubation. Heart rate ,Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure, was monitored and recorded just before study drug administration (T)) {i.e. baseline in our study}, and before extubation (T-1), one (T-2), three (T-3), five (T-4) and ten (T-5) minutes after Extubation. On comparison of mean heart rate (HR) in both the study groups at different times of observation (T0-T5), when compared to the baseline; mean heart rate (HR) was observed to decline much more in group E than in group P. Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure were comparable at baseline (T-0), declined up to 5minutes(T-4) and comparable after 10 minutes. At no point the mean SPO2 reduced below 98%. Propofol   was observed to cause sedation in 8 patients and 2 patients in esmolol group experienced moderate cough at or after extubation. No major complication occurred in any patients included in our study. It was concluded that attenuation of haemodynamic response to extubation by injection esmolol was more effective than injection propofol. Even though less effective IV propofol too attenuated the hemodynamic resonse to extubation effectively.

Keywords: Esmlol, Propofol, Extubation, Hemodynamic resonse, Attenuation.

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Corresponding Author

Dr G. Laxminarsaiah

Kakatiya Medical College, Warangal, Telangana State, India

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