EFFECT OF ESMOLOL INFUSION ON MYOCARDIAL OXYGEN CONSUMPTION DURING INTUBATION, EXTUBATION IN PATIENTS UNDERGOING GENERAL ANAESTHESIA

DR.R.GANESAPANDIAN; Dr.SRINIDHI.V

Volume : VIII, Issue : III, March - 2018

EFFECT OF ESMOLOL INFUSION ON MYOCARDIAL OXYGEN CONSUMPTION DURING INTUBATION, EXTUBATION IN PATIENTS UNDERGOING GENERAL ANAESTHESIA

Dr. R. Ganesapandian, Dr. Srinidhi. V

Abstract :

Mechanical stimulation of the receptors present in the larynx, trachea results in both respiratory and cardiovascular reflex responses during intubation. Heart rate is a major determinant of myocardial oxygen consumption and cardiac workload, so decreasing the heart rate will increase the ischemic threshold and improve the cardiac performance Aim: evaluation of the effect of esmolol infusion on myocardial oxygen consumption during intubation, extubation. Methodology: A prospective study including 100 patients undergoing elective surgeries under general anaesthesia. Group E (esmolol) 0.5mg/kg bolus dose over 30 s starting 5 min before intubation. 0.5mg/kg bolus dose over 30 s followed by a continuous esmolol infusion of 100 microgm/kg/min starting 10 min before end of surgery till 5 min after extubation Group C received saline as above, loading dose followed by same volume of infusion.The parameters monitored at HR, SBP,DBP,RPP at various time intervals Results:We found that in Group E (esmolol) patients had a stable hemodynamics with the start of the esmolol loading /infusion both during intubation and extubation when compared to the control group. Group E( esmolol) had a lower RPP when compared to the control group during laryngoscopy thereby reducing the myocardial oxygen demand ,hence by reducing the risk of periop ischemia. Conclusion: esmolol is a safe, effective drug that can be used in patients undergoing general anaesthesia to attenuate the laryngoscopy responses to both intubation and extubation , thereby reducing the myocardial oxygen consumption and perioperative risk of myocardial ischemia.