Author(s): Jagadish Chandra Mishra
Laryngoscopy and tracheal intubation produce sympathetic overdrive by catecholamine release resulting in complications like hypertension, tachycardia, cardiac arrhythmias, cerebrovascular accidents, which can be detrimental to the patient’s life. Various agents are being tried to combat the intubation responses over years and dexmedetomidine and esmolol are the newer ones.
The aim of the study is to compare dexmedetomidine versus esmolol in attenuating haemodynamic responses during and immediately after tracheal intubation.
MATERIALS AND METHODS
Ninety patients scheduled for general anaesthesia were divided into three groups, D, E and C with 30 patients in each group. Group-D patients received dexmedetomidine 0.5 mcg/kg; Group-E patients received esmolol 0.5 mg/kg and Group-C patients received 0.9% 20 mL saline as intravenous premedication over 5 minutes before anaesthesia induction. Systolic, diastolic and mean arterial pressures along with heart rate were measured at various time points. The percentage change in haemodynamic parameters at different time points from the baseline were compared between the groups.
Statistical Analysis Used- Descriptive and inferential statistical methods were used to analyse the data.
Settings and Design- This was a prospective randomised double-blind controlled study.
The percentage change of all haemodynamic parameters from baseline were less in the dexmedetomidine group than in esmolol group at all time points of measurement. However, a statistically significant differences were observed often at the time points between endotracheal intubation and at 3 mins. after tracheal intubation. The increase in heart rate, systolic, diastolic and mean arterial pressures were significantly lesser in dexmedetomidine group (P<0.05) than compared to other two groups immediately after intubation to 3rd minute.
Dexmedetomidine is superior to esmolol in attenuating the haemodynamic responses to laryngoscopy and immediately (<3 minutes) after tracheal intubation