Key result
IV esmolol attenuates post-intubation HR and BP increases better than oral gabapentin.
Why the study?
Gabapentin and esmolol individually attenuate the pressor response to laryngoscopy and tracheal intubation, but their comparative efficacy had not been evaluated.
Does gabapentin compared to esmolol improve haemodynamic response during intubation and laryngoscopy?
RCT (n=120)
Double-blind
Randomized
No
Does gabapentin compared to esmolol improve haemodynamic response during intubation and laryngoscopy?
p-value: p=<0.001
Esmolol attenuates intubation hemodynamics better than gabapentin; supports preferential use in anesthesia and further head-to-head RCTs.
The suppression of neurovegetative response to laryngoscopy and intubation has been tried out using several pharmacological agents, such as opioids, local anaesthetics, β-blockers and α2 agonists.Gabapentin an anticonvulsant, while esmolol is a cardioselective β1 blocker and a class II antiarrhythmic, they have shown to attenuate pressor response to direct laryngoscopy and tracheal intubation individually.Given these variable characteristics of two drugs, the present study, a prospective randomized double blind aimed to compare their efficacy against haemodynamic response during intubation and laryngoscopy.
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AB et al. (2018) conducted an RCT in Hemodynamic response to laryngoscopy and endotracheal intubation (n=120). Esmolol vs. Gabapentin 600 mg oral was evaluated on Change in blood pressure (SBP, DBP, MAP) and heart rate following laryngoscopy and endotracheal intubation (p=<0.001). Esmolol (1.5 mg/kg IV) provided significantly better attenuation of heart rate and blood pressure increases immediately following laryngoscopy and intubation compared to 600 mg oral gabapentin (p<0.001).
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