Comparison of esmolol versus combination of esmolol and fentanyl in preventing cardiovascular stress response to intubation

Authors

  • Rahul Bhalke Department of Anaesthesia, G.M.C.H. Aurangabad, Maharashtra, India
  • Maroti S. Karale Department of medicine, G.M.C.H. Latur, Maharashtra, India
  • Umesh Deshmukh Department of Anaesthesia, G.M.C.H. Latur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20170309

Keywords:

Esmolol, Fentanyl, Cardiovascular Stress, Laryngoscopy, Endotracheal intubation

Abstract

 

Background: A number of cardiovascular responses occur during laryngoscopy and intubation which can have serious consequences during anaesthesia.We planned to conduct a study to evaluate effectiveness of intravenous Esmolol and intravenous Fentanyl in attenuating hemodynamic stress response to laryngoscopy and endotracheal intubation.

Methods: A prospective, observational, randomized, double blind comparative clinical study, conducted on 60 cases of ASA grade I/II patients undergoing elective abdominal surgery under general anesthesia. The data obtained was divided in the two groups based on drug used 5 min prior to induction, Group 1 (I.V. Esmolol 2 mg/kg) and Group 2 (I.V. Esmolol 2 mg/kg & I.V. Fentanyl 2 µg/kg). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were measured at various time intervals.

Results: There was no significant difference in HR, SBP, DBP, MAP after premedication and induction in both the groups. However at intubation, both groups showed an increase in HR, SBP, DBP and MAP but the rise was attenuated in both groups. Increase in HR was more in group 1 as compared to group 2 and it was statistically significant at 01 and 02 minutes post intubation. The increase in SBP was statistically significant at 00, 01 and 02 minutes post intubation. The increase in MAP was statistically significant immediately after induction, at 00, 01, 02, 05 and 10 minutes post intubation.  

Conclusions: Combination of intravenous Esmolol and intravenous Fentanyl is more effective in attenuating heart rate, systolic, diastolic and mean arterial pressure response to intubation than intravenous Esmolol alone.

Author Biographies

Rahul Bhalke, Department of Anaesthesia, G.M.C.H. Aurangabad, Maharashtra, India

Assistant Professor, Department of Anaesthesia, Govt. medical college, Aurangabad

Maroti S. Karale, Department of medicine, G.M.C.H. Latur, Maharashtra, India

Assistant Professor, Department of Medicine, Govt. medical college, Latur

Umesh Deshmukh, Department of Anaesthesia, G.M.C.H. Latur, Maharashtra, India

Assistant Professor, Department of Anaesthesia, Govt. medical college, Latur

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Published

2017-01-25

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Original Research Articles