Tracheal extubation carries higher complication rates compared to intubation during anaesthesia (GA). Thus, various drugs are used to attenuate hemodynamic and cough reflex during extubation. We investigated if intravenous (IV) lignocaine and esmolol, given prior extubation, was able to achieve that in patients under GA. In this prospective, double-blinded, randomised study, 68 hypertensive patients on treatment undergoing GA were . Group L received IV lignocaine 1 mg/kg while Group E received IV 1.5 mg/kg, 2 minutes before extubation. Heart rate (HR), systolic blood (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) recorded at the following interval: before study drug administration (T-0), extubation (T-1), 1 minute (T-2), 3 minutes (T-3), 5 minutes (T-4) and 10 (T-5) post-extubation. Group L showed significantly increase in HR at T-2 SBP and MAP increased significantly from T-1 until T-5. Group E showed significant reduction in HR at T-1 up to T-5 and significantly lower HR at T-1 T-2 compared to Group L. Group E showed stable SBP, DBP and MAP at intervals. In conclusion, IV esmolol at 1.5 mg/kg was able to attenuate the response more pronounced when compared to IV lignocaine at 1 mg/kg from extubation stress in patients with hypertension on treatment. Both and esmolol were equally effective in suppressing cough reflex during .
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Hatane et al. (2019) studied this question.