Key result
Intravenous esmolol (2 mg/kg) was significantly more effective than intravenous magnesium sulfate (50 mg/kg) in attenuating the haemodynamic stress response following laryngoscopy and intubation.
Why the study?
Direct laryngoscopy and endotracheal intubation trigger powerful cardiovascular responses that can be hazardous in patients with cardiovascular disease, prompting a comparison of esmolol and magnesium sulphate for attenuation.
Does IV esmolol or IV magnesium sulphate reduce haemodynamic response to laryngoscopy and endotracheal intubation in ASA I and II adult patients undergoing elective surgeries?
RCT (n=120)
Double-blind
Computer generated random numbers
Yes
Does IV esmolol or IV magnesium sulphate reduce haemodynamic response to laryngoscopy and endotracheal intubation in ASA I and II adult patients undergoing elective surgeries?
p-value: p=<0.05
IV esmolol 2 mg/kg is more effective than IV magnesium sulfate 50 mg/kg in attenuating the haemodynamic stress response to laryngoscopy and endotracheal intubation.
Esmolol 2 mg/kg attenuates intubation hemodynamics more effectively than magnesium sulfate; supports preferential use in at-risk patients and extends comparative RCT data.
Background & Objectives: Direct laryngoscopy and endotracheal intubation always trigger powerful cardiovascular responses. It may be well tolerated in healthy people, but may be hazardous in patients with hypertension, tachycardia, myocardial infarction, and other complications.Various attempts have been made to attenuate these responses. The present study has been undertaken to make a comparative study of both drugs Esmolol and Magnesium Sulphate in attenuating the haemodynamic changes during laryngoscopy and tracheal intubation.Methods: After IEC approval, a prospective, randomized, double blinded study was conducted on 120ASA I and II adult patients undergoing elective surgeries under general anaesthesia. Patients were randomly divided into three groups of 40 patients in each group - N, M, and E. Group - “N” received normal saline IV, group -“M” received 50 mg per kg magnesium sulfate IV and group -“E” received 2 mg per kg esmolol IV 4 min before intubation. Heart rate, systolic blood pressure, diastolic blood pressure and Mean arterial pressure were measured before induction as baseline, just after giving the study drugs and after tracheal intubation at 1, 3, 5, 10, 15, 30, 45 and 90 minutes. Patients were also observed for any complications.Results: Baseline mean heart rate and mean blood pressure were compared in all the groups (<0.05). Both IV Magnesium sulphate and IV esmolol showed attenuation of hemodynamic response to laryngoscopy and endotracheal intubation which was statistically significant (<0.05). In which esmolol was more effective than magnesium sulfate which was also statistically significant. Conclusion: IV esmolol 2 mg/kg as a bolus done proved to be more effective than IV magnesium sulfate 50 mg/kg in attenuating haemodynamic stress response following laryngoscopy and intubation.
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Kumar et al. (2022) conducted an RCT in Elective surgeries under general anaesthesia requiring endotracheal intubation (n=120). Esmolol and Magnesium Sulphate vs. Normal saline IV was evaluated on Attenuation of haemodynamic response (heart rate and blood pressure) to laryngoscopy and endotracheal intubation (p=<0.05). Intravenous esmolol (2 mg/kg) was significantly more effective than intravenous magnesium sulfate (50 mg/kg) in attenuating the haemodynamic stress response following laryngoscopy and intubation.
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