Dexmedetomidine and Esmolol on Prevention of Haemodynamic Response to Laryngoscopy and Tracheal Intubation- A Randomised Prospective Study

BACKGROUNDLaryngoscopy and tracheal intubation manifests as transient, but distinct tachycardia and hypertension due to exaggerated sympathoadrenal response.The aim of this study is to compare the efficacy of dexmedetomidine (Intravenous infusion at a dose of 1 mcg/kg) and esmolol (intravenous infusion at a dose of 1 mg/kg) in blunting the haemodynamic response secondary to laryngoscopy and tracheal intubation.Settings and Design of Study-A prospective, randomised, double-blinded study in Gauhati Medical College and Hospital, Assam. MATERIALS AND METHODSAll adult patients of both sex scheduled for elective surgery under general anaesthesia were included.They were selected by lottery method to divide into two groups, Group E and Group D with 30 cases in each group.Group E received 1 mg/kg esmolol diluted to 10 mL with normal saline and Group E received dexmedetomidine 1 mcg/kg diluted to 10 mL with normal saline as intravenous infusion over 10 minutes before induction of anaesthesia. RESULTSResults suggested that at 1 minute after laryngoscopy and intubation, in Group E the increase in heart rate was 7.66% from the baseline which was statistically significant (p < 0.05).In Group D the increase in heart rate from baseline was 1.90%, which was statistically insignificant.At 3 minutes after intubation when both the groups were compared, the increase in mean heart rate was higher in Group E which was highly significant (p < 0.001). CONCLUSIONBoth the drugs attenuated the pressure response.Of the two drugs administered, dexmedetomidine 1.0 μg/kg provides a consistent, reliable and effective attenuation of pressure responses when compared to esmolol 1.0 mg/kg.