Key result
Intravenous esmolol 1.5 mg/kg significantly attenuated the heart rate response immediately after intubation compared to control (88.67 vs 101.60 bpm, p<0.001), but failed to satisfactorily prevent the rise in blood pressure.
Why the study?
The study was conducted to compare the efficacy of intravenous esmolol with a control group in attenuating cardiovascular responses to laryngoscopy and endotracheal intubation.
Does intravenous esmolol 1.5 mg/kg attenuate the cardiovascular responses (heart rate and blood pressure) to laryngoscopy and endotracheal intubation in normotensive adults undergoing elective surgery?
RCT (n=60)
Open-label
Randomized
No
Does intravenous esmolol 1.5 mg/kg attenuate the cardiovascular responses (heart rate and blood pressure) to laryngoscopy and endotracheal intubation in normotensive adults undergoing elective surgery?
Absolute Event Rate: 88.67% vs 101.6%
p-value: p=<0.001
Intravenous esmolol 1.5 mg/kg effectively attenuates the heart rate response to laryngoscopy and intubation but fails to provide sustained control of blood pressure in normotensive patients.
Esmolol 1.5 mg/kg attenuates intubation tachycardia but offers only transient BP control; supports selective use and adjunctive strategies in normotensive patients.
Background: Objective is to compare the efficacy of intravenous Esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation with control group.Methods: Study was done on 60 adults, ASA grade I or II normotensive patients, undergoing elective surgery under general anaesthesia and willing to participate. These patients where be randomly allocated in to either group C (Control) or E (Esmolol). Group ‘C’ Control group. 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), SBP, DBP and MAP were recorded at baseline (taken half an hour prior to anaesthesia), Before sedation, After induction but before intubation, Immediately after endotracheal intubation and Thereafter at 1, 2, 3, 4, 5 and 10 minutes.Results: Heart rate was lower in Group E as compared to Group C, and there was statistically significant difference immediately after intubation till 4 minutes after intubation. While Blood pressure was lower in Group E as compared to Group C, and there was statistically significant difference only immediately after intubation.Conclusions: In Normotensive patients requiring general anaesthesia with laryngoscopy and intubation, authors conclude that intravenous Esmolol 1.5 mg/kg attenuated Heart rate response but fails to satisfactorily prevent rise in blood pressure.
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Chodankar et al. (2020) conducted an RCT in Elective surgery requiring general anesthesia and endotracheal intubation (n=60). Intravenous Esmolol vs. Control (no esmolol) was evaluated on Heart rate immediately after intubation (p=<0.001). Intravenous esmolol 1.5 mg/kg significantly attenuated the heart rate response immediately after intubation compared to control (88.67 vs 101.60 bpm, p<0.001), but failed to satisfactorily prevent the rise in blood pressure.
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