Effect of Esmolol hydrochloride on attenuation of stress response during laryngoscopy and intubation in ear, nose and throat (ENT) procedures

Abstract

Introduction: Various techniques and pharmacologic interventions have come in practice to blunt the hemodynamic responses of laryngoscopy and intubation. Beta blocker Esmolol is the drug used in our study to attenuate the stress response of laryngoscopy and intubation. The aim of our study was to observe the efficacy of Esmolol hydrochloride on cardiovascular responses to laryngoscopy and intubation.

Methods: Two groups of 25 patients each were taken as control group and Esmolol group and Esmolol 1.5 mgs per kg IV as bolus dose was administered to Esmolol group 3 minutes prior to induction of anaesthesia followed by laryngoscopy and intubation. The vital parameters were recorded every minute for five minutes.

Results: There were no significant differences in the basal parameters in both the groups before giving Esmolol and with respect to age, sex and ASA grading. There was significant reduction in heart rate (6.4 %) at the time of induction as compared to rise of heart rate (15.16%) in control group. This was highly significant. Same way – there was fall in systolic blood pressure (7.69%) in esmolol group in comparison to a rise of 14.28% in control group. Diastolic blood pressure in esmolol group showed a fall of 2.9% as compared to a rise of 21.2% in control group. The RPP was found to decrease by 13.1% in esmolol group in comparison to a rise of 31.2 % in control group which was also highly statistically significant.

Conclusion: Esmolol hydrochloride is proved to be a very effective drug, ultrashort acting rapid onset and offset of action, easily titrable, so highly useful in reducing the stress response of laryngoscopy and intubation.