Comparative Evaluation of Dexmedetomidine and Esmolol for Attenuation of Intubation Stress Response in well Controlled Hypertensive Patients – A Double-Blind Randomized Control Study

ABSTRACT

Introduction: Laryngoscopy and tracheal intubation provokesa transient and marked sympathetic response that manifests asan increase in BP and HR, with the potential for developmentof arrhythmias. Study aimed to compare the efficacy ofintravenous Dexmedetomidine and Esmolol in attenuating thecardiovascular stress responses accompanying laryngoscopyand endotracheal intubation in well-controlled hypertensivepatients.Material and Methods: 60 hypertensive patients undergoingelective non cardiac surgery were included in the study.Patients were divided into 2 groups, Group D receivedDexmedetomidine 1µg/kg and Group E received esmolol 1.5mg/kg. HR, SAP, DAP, MAP were recorded.Results: There is statistical significant lower HR, SAP,DAP and MAP in group D compared to group E at T4 to T7.Intragroup analysis showed there is no statistically significantchange of HR, SAP, DAP and MAP compared to baseline inGroup D and returns to baseline at 10 minutes. Intragroupanalysis showed there is statistically significant (Higher)change of HR, SAP, DAP and MAP compared to baseline inGroup E at T5 to T8 and returns to baseline at 15 minutes.Conclusion: In controlled hypertensive patients,administration of dexmedetomidine infusion before inductionof anaesthesia blunts the haemodynamic response tolaryngoscopy and endotracheal intubation.