Comparative Study Between Intravenous Dexmedetomidine and Esmolol in Attenuation of Haemodynamic Stress Response During Endotracheal Intubation and Laryngoscopy

BACKGROUNDLaryngoscopy and endotracheal intubation produce sympathetic overdrive by catecholamine release resulting in hypertension and tachycardia.Various agents are being tried to combat the intubation response.The aim of this study is to compare the efficacy of dexmedetomidine which is a highly selective alpha-2 agonist with an ultrashort-acting beta blocker esmolol in attenuating the haemodynamic stress response secondary to laryngoscopy and endotracheal intubation. MATERIALS AND METHODSAfter obtaining an approval from Institutional Ethics Committee and after having informed and written consent from each patient, 60 adult patients scheduled for elective surgery under general anaesthesia were selected and were provided general anaesthesia with endotracheal intubation for all patients.Patients were randomly allocated into two groups, Group E and Group D with 30 cases in each group.Group D -Received Dexmedetomidine 1 mcg/kg, Group E -Received Esmolol 0.5 mg/kg.Patient's HR, SBP, DBP and MAP was recorded at baseline, after infusion of study drug, after induction of anaesthesia, immediately and 1, 3, 5 and 7 minutes after intubation.All the study parameters were collected and documented by a single anaesthesiologist in all cases, who was blinded for the content in the syringe and study protocol. RESULTSThe percentage change of all haemodynamic parameters from baseline were less in the dexmedetomidine group than in esmolol group at all time points of measurement.However, a statistically significant difference was observed often at time points within 1 minute and 3 minutes after tracheal intubation. CONCLUSIONThe incidence of hypertension and tachycardia following laryngoscopy and intubation were significantly lower in patients receiving intravenous dexmedetomidine infusion when compared with patients receiving intravenous esmolol infusion.