Bolus administration of Esmolol versus fentanyl for pressor response attenuation during laryngoscopy & endotracheal intubation-a comparative study

Dr. T. Aseesh; Dr. Md. Arif Jahan

Volume : VII, Issue : XI, November - 2017

Bolus administration of Esmolol versus fentanyl for pressor response attenuation during laryngoscopy & endotracheal intubation-a comparative study

Dr. T. Aseesh, Dr. Md. Arif Jahan

Abstract :

Background:

Laryngoscopy and intubation is almost always associated with hemodynamic changes due to sympathetic discharge caused by epipharyngeal & laryngopharyngeal stimulation which has increase in endogenous catecholamines. There is increase in heart rate, BP, cardiac arrhythmias.

Aim and objective:

Study is planned to compare clinical evaluation of single bolus dose of esmolol and fentanyl in attenuating cvs response to laryngotracheal stimulation in healthy normotensive patients in order to reduce life threatening complications during induction of anesthesia.

Methods:

60 adult ASA grade I and ASA grade II patients & Mallampati grade I of both sexes and age ranging from 20–60 years were included in the study who underwent elective gynaecological and other general surgeries.

Patients were divided into 2 groups Group I consists of 30 patients , where esmolol 1.5 mg/ kg I.V bolus dose and group II consists of 30 patients where fentanyl 2 mcg/ kg body I.V bolus dose was given.Study drug was injected 3 min before intubation. Heart rate, systemic arterial pressure and ECG were recorded as baseline and after administration of study drug at intubation and thereafter.

Results:

Reading of heart rate, BP were compared with baseline and among each group. The rise in HR was minimal in esmolol group and was highly significant.

Conclusion:

Esmolol 1.5 mg/ kg as a bolus dose proved to be effective in attenuating rise in HR following laryngoscopy and intubation while the rise in BP was suppressed but not abolished by bolus dose of esmolol