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Attenuation of Hemodynamic Stress Response to Laryngoscopy and Intubation in Elective ENT Surgeries

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Introduction: The sympathoadrenal response to laryngoscopy and intubation is hazardous in patients with hypertension, coronary artery disease, cerebrovascular disease and intracranial pathology. Various drugs are used to attenuate this stress response. Aim and Objectives: This study compares the efficacy of Esmolol and Magnesium Sulphate in attenuating the hemodynamic stress response to laryngoscopy and intubation. Methodology: Randomized prospective single blinded study was designed. Ninety patients of ASA PS I and II were randomly allocated into three groups of thirty each. P—received normal saline, E—Esmolol 1.5mg/kg, M—Magnesium Sulphate 50mg/kg. Statistical Analysis: ANOVA and Pearson chi square test were used. A p value <0.05 was considered as statistically significant. Tukey’s HSD was used to compare between groups. Observations and Results: The following observations were made. 1. Group E showed maximum attenuation of heart rate and blood pressure. 2. Group M also showed significant attenuation of blood pressure response but produced tachycardia on infusion of the drug. Heart rate response was not statistically significant compared to group E. 3. All patients recovered well. 4. Incidence of side effects was not significant between the groups. Conclusion: Esmolol is effective in blunting the intubation response followed by Magnesium Sulphate which blunts the hypertensive response but produces tachycardia during infusion of the drug. Placebo was ineffective in blunting hemodynamic stress response.

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Introduction: The sympathoadrenal response to laryngoscopy and intubation is hazardous in patients with hypertension, coronary artery disease, cerebrovascular disease and intracranial pathology. Various drugs are used to attenuate this stress response. Aim and Objectives: This study compares the efficacy of Esmolol and Magnesium Sulphate in attenuating the hemodynamic stress response to laryngoscopy and intubation. Methodology: Randomized prospective single blinded study was designed. Ninety patients of ASA PS I and II were randomly allocated into three groups of thirty each. P—received normal saline, E—Esmolol 1.5mg/kg, M—Magnesium Sulphate 50mg/kg. Statistical Analysis: ANOVA and Pearson chi square test were used. A p value <0.05 was considered as statistically significant. Tukey’s HSD was used to compare between groups. Observations and Results: The following observations were made. 1. Group E showed maximum attenuation of heart rate and blood pressure. 2. Group M also showed significant attenuation of blood pressure response but produced tachycardia on infusion of the drug. Heart rate response was not statistically significant compared to group E. 3. All patients recovered well. 4. Incidence of side effects was not significant between the groups. Conclusion: Esmolol is effective in blunting the intubation response followed by Magnesium Sulphate which blunts the hypertensive response but produces tachycardia during infusion of the drug. Placebo was ineffective in blunting hemodynamic stress response.

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This page is a summary of: Comparison of Esmolol and Magnesium Sulphate for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Intubation in Elective ENT Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5218.6.
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