A comparative study of the efficacy of intravenous esmolol and intravenous magnesium sulphate in attenuating haemodynamic response to laryngoscopy and endotracheal intubation

Abstract

Background & Objectives: Direct laryngoscopy and endotracheal intubation always trigger powerful cardiovascular responses. It may be well tolerated in healthy people, but may be hazardous in patients with hypertension, tachycardia, myocardial infarction, and other complications.Various attempts have been made to attenuate these responses. The present study has been undertaken to make a comparative study of both drugs Esmolol and Magnesium Sulphate in attenuating the haemodynamic changes during laryngoscopy and tracheal intubation.Methods: After IEC approval, a prospective, randomized, double blinded study was conducted on 120ASA I and II adult patients undergoing elective surgeries under general anaesthesia. Patients were randomly divided into three groups of 40 patients in each group - N, M, and E. Group - “N” received normal saline IV, group -“M” received 50 mg per kg magnesium sulfate IV and group -“E” received 2 mg per kg esmolol IV 4 min before intubation. Heart rate, systolic blood pressure, diastolic blood pressure and Mean arterial pressure were measured before induction as baseline, just after giving the study drugs and after tracheal intubation at 1, 3, 5, 10, 15, 30, 45 and 90 minutes. Patients were also observed for any complications.Results: Baseline mean heart rate and mean blood pressure were compared in all the groups (<0.05). Both IV Magnesium sulphate and IV esmolol showed attenuation of hemodynamic response to laryngoscopy and endotracheal intubation which was statistically significant (<0.05). In which esmolol was more effective than magnesium sulfate which was also statistically significant. Conclusion: IV esmolol 2 mg/kg as a bolus done proved to be more effective than IV magnesium sulfate 50 mg/kg in attenuating haemodynamic stress response following laryngoscopy and intubation.