Efficacy of Dexmedetomidine and Esmolol for attenuation of cardiovascular response during laryngoscopy and endotracheal intubation in cases with controlled hypertension

Abstract

Background: Laryngoscopy and endotracheal intubation evokes tachycardia and hypertension in cases with cardiovascular diseases undergoing anaesthesia. This was successfully reduced by opioids, inhaled anaesthetics, vasodilators and adrenergic blockers. This study was designed to assess the efficacy of 1μg/kg Dexmedetomidine and 1.5 mg / kg Esmolol in attenuation of cardiovascular response during laryngoscopy and endotracheal intubation in cases with controlled hypertensionMaterials and Methods: A total 100 controlled hypertensive cases undergoing general anaesthesia were randomly divided in to two groups Group 1 administered with 1μg/kg Dexmedetomidine in 100ml normal saline, 2 minutes before intubation and group 2, with 1.5 mg / kg Esmolol, 2 minutes before intubation. Heart rate, Systolic blood pressure, diadtolic blood pressure, mean arterial pressure and SpO2 were recorded at Baseline, after drug administration, after induction, at 0 min, 1min, 3min, 5min, 10min, 15 minutes after intubation.Results: The mean difference of age (p=0.722), sex (p=0.358) and history of anti-hypertensive drug usage (p=0.562) between two study groups was statistically not significant. After induction, all raised baseline parameters were normalized after 10 minutes in group 1 and after 15 minutes in group 2.Conclusion: Dexmedetomidine is efficient in attenuating the rise in mean heart rate, mean systolic blood pressure and mean diastolic blood pressure. Esmolol had longer duration in attenuation of cardiovascular response.