Background: The pressure response to laryngoscopy and endotracheal intubation has been recognized since long, resulting a rise in pulse and blood pressure.

Aims and Objectives: To compare the safety and efficacy of standard IV bolus doses of lidocaine, esmolol, and nitroglycerin in modifying the acute hemodynamic response to laryngoscopy and tracheal intubation.

Materials and Methods: The study sample of 60 normotensive patients were categorized in to 4 groups. Group 1 = saline 5 ml IV at time 0 minutes; Group 2 = lidocaine 1.5 mgikg IV at time 1 minute; Group 3 = esmolol 1.4 mglkg IV at time 2 minutes and Group 4 = nitroglycerin 2 µg/kg IV at time 3 minutes. The parameters measured were Mean arterial pressure and Heart Rate.

Results:  MAP increased significantly following tracheal intubation in all four groups (control 47%±20%, lidocaine 53% ± 27%, esmolol 24%±12%, nitroglycerin 43% ±22%) compared with preinduction baseline values. in the esmolol group, the increase in HR was significantly lower than in the other three groups.

Conclusion: Esmolol was significantly more effective than either lidocaine or nitroglycerin in controlling the increase in HR, and in minimizing the increase in MAP following tracheal intubation.

Keywords: Esmolol, Hemodynamic Response, Intubation, Laryngoscopy, Lidocaine, Nitroglycerin.

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Dr Ramesh Pendela

Assistant Professor, Prathima Institute of Medical Sciences, Karimnagar, Telangana, India