Key result
Intravenous dexmedetomidine (1 mcg/kg) significantly attenuated the systolic blood pressure response immediately after intubation compared to esmolol (124.5 vs 155.1 mmHg, p<0.001).
Why the study?
The objective was to compare the efficacy of intravenous dexmedetomidine and esmolol in attenuating cardiovascular pressor responses to laryngoscopy and endotracheal intubation.
Does intravenous dexmedetomidine reduce cardiovascular pressor responses to laryngoscopy and endotracheal intubation compared to intravenous esmolol in normotensive adults undergoing elective surgery?
RCT (n=60)
Open-label
Randomly allocated
No
Does intravenous dexmedetomidine reduce cardiovascular pressor responses to laryngoscopy and endotracheal intubation compared to intravenous esmolol in normotensive adults undergoing elective surgery?
Absolute Event Rate: 124.5% vs 155.07%
p-value: p=<0.001
Intravenous dexmedetomidine (1 mcg/kg) is more effective than esmolol (1.5 mg/kg) in attenuating the hemodynamic stress response to laryngoscopy and endotracheal intubation in normotensive adults.
Dexmedetomidine may be preferred over esmolol to blunt intubation pressor responses in normotensive adults; extends RCT evidence for alpha-2 agonism in airway management.
Background: The objective of this study was to compare the efficacy of intravenous dexmedetomidine and esmolol in attenuating the cardiovascular pressor responses to laryngoscopy and endotracheal intubation.Method: Study was done on 60 adults, American society of anesthesiologists (ASA) grade I or II normotensive patients, undergoing elective surgery under general anesthesia and willing to participate. These patients were randomly allocated to either group E (esmolol) or D (dexmedetomidine). Group ‘D’, patients were given intravenous dexmedetomidine infusion 1 mcg/kg over 10 minutes, 3 minutes before start of laryngoscopy. Group ‘E’, patients were given intravenous esmolol 1.5 mg/kg 2 minutes before start of laryngoscopy. All patients were premedicated, induced and intubated using thiopentone and succinyl choline as per the protocol. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at baseline (taken half an hour prior to anesthesia), before sedation, after induction but before intubation, immediately after endotracheal intubation and thereafter at 1, 2, 3, 4, 5 and 10 minutes.Results: Immediately after intubation, HR was similar in group D and group E, thereafter HR remained higher in group E as compared to group D, and difference was statistically significant. SBP, DBP and MAP recorded was higher in group E as compared to group D, and difference was statistically significant.Conclusion: Authors conclude that intravenous dexmedetomidine 1 ug/kg is better drug to attenuate hemodynamic response to laryngoscopy and intubation as compared to intravenous esmolol 1.5 mg/kg.
No takes yet. Share an insight, caveat, or question.
Chodankar et al. (2020) conducted an RCT in Cardiovascular response to laryngoscopy and endotracheal intubation (n=60). Dexmedetomidine vs. Esmolol 1.5 mg/kg intravenous was evaluated on Systolic blood pressure immediately after intubation (p=<0.001). Intravenous dexmedetomidine (1 mcg/kg) significantly attenuated the systolic blood pressure response immediately after intubation compared to esmolol (124.5 vs 155.1 mmHg, p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: