Comparison of the efficacy of dexmedetomidine and esmolol in the treatment of increased hemodynamic response during the recovery period

Objectives: Our aim was to compare effectiveness of esmolol and dexmedetomidine in the treatment of increased hemodynamic response during anesthesia recovery period. Materials and methods: 60 ASA I-II patients whom scheduled for elective surgery with endotracheal intubation were randomized before extubation according to their hemodynamic parameters that were increased 20% of their baseline values in order to receive 1mg/kg esmolol (Group Esmolol, n= 30) or 0.5 µg/kg dexmedetomidine (Group Dexmedetomidine, n= 30). Heart rate (HR), systolic and diastolic blood pressures (SBP,DBP), peripheral oxygen saturation (SpO2), end tidal carbon dioxide (ETCO2) values, extubation time, recovery time were recorded. The duration till having pain requiring analgesic was recorded and cognitive functions were evaluated with short memory orientation concentration test at 20th and 50th minutes. Results: After drug, HR reductions were significant at all periods in group Dexmedetomidine (Z2-Z10: p<0.001, Z11:p=0.001, Z12, p=0.006). In group Dexmedetomidine SBP value was high at 3rd min after drug (p<0.001), and SBP values were lower in all periods before and after extubation (Z6- Z10: p<0.001, Z11: p=0.02, Z12: p=0.04). In group Dexmedetomidine DBP value was higher at 1st min after drug (p=0.001), DBP values were lower at 10th min after drug and before extubation (p= 0.045, p=0.001). The duration of pain requiring analgesic and recovery period were longer in dexmedetomidine group (p<0.001, p<0.001). Conclusions: Although esmolol and dexmedetotimidine attenuated hemodynamic response during recovery period, dexmedetotimidine was more effective in hemodynamic stabilization and the duration of pain requiring analgesic was longer. Esmolol provided faster recovery time.