IJSR - International Journal of Scientific Research

Deepika Shukla; Madhuri Dhabarde

Volume : V, Issue : V, May - 2016

Tracheal Intubation in Patients with Pregnancy Induced Hypertension: Comparative Study between Esmolol, Diltiazem & Magnesium Sulphate

Deepika Shukla, Madhuri Dhabarde

Abstract :

Background: Reflex changes in the cardiovascular system after laryngoscopy and intubation are most marked. They manifest themselves in the form of tachycardia, hypertension and cardiac arrhythmias, ectopics being most common. In patients with pregnancy induced hypertension, these reflex responses are greatly exaggerated. The present study was undertaken to compare the effect of intravenous Esmolol, intravenous Diltiazem and intravenous Magnesium Sulphate on blunting the haemodynamic response to endotracheal intubation in patients with pregnancy induced hypertension. Materials & Methods: The study was conducted in 120 patients with PIH, coming to emergency and outdoor clinic, for undergoing surgery in a tertiary care centre. All 120 patients were assigned to one of the four groups of 30 each before induction of anaesthesia using a random number table: Group I: Normal Saline (controls), Group II: Inj. Esmolol, Group III: Inj. Diltiazem and; Group IV: Inj. Magnesium Sulphate. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded at following stages: Preoperative, after giving the study drug, immediately after intubation and at 1 minute, 3 minutes and 5 minutes after intubation. Statistical analysis was done using SPSS ver. 21. Results: Significant fall in pulse rate in group II, insignificant rise in group III and significant rise (p<0.01) in group IV was observed after giving the study drug. Only in group II (esmolol), there was no significant rise in heart rate at any time interval. In group I (control) and III (diltiazem) there is significant increase in heart rate upto 3 minutes after intubation. In group IV (Mgso4), pulse rate is significantly higher at all time intervals. After giving the study drug, there is significant fall in mean arterial pressure in group II & III and insignificant fall in group IV. There is significant increase in mean arterial pressure in group I, II and III immediately after intubation and 1 minute after intubation while in control group, upto 3 minutes after intubation. In group IV there is insignificant difference at all the time intervals (all the values are below basal values in MgSO4 group). Conclusion: Esmolol due to its rapid onset and short duration of action is a suitable drug for the attenuation of the haemodynamic response to laryngoscopy and intubation.