Comparative Study of Haemodynamic Responses to Laryngoscopy and Oral Endotracheal Intubation in Healthy Normotensive Adults with Prior Administration of Lignocaine and Esmolol Hydrochloride

ABSTRACT

The frequent occurrence of cardiovascular responses to laryngoscopy and tracheal intubation has attracted the attention of anaesthesiologists for more than five decades. The reason for this is the occasional report of sudden death immediately after intubation and increasing awareness about the common occurrence of potentially dangerous responses such as tachycardia, hypertension and arrhythmiasWe wanted to study, measure and compare the haemodynamic responses to laryngoscopy and oral endotracheal intubation in healthy normotensive adults with prior administration of injection lignocaine and injection esmolol hydrochloride.METHODS75 patients belonging to ASA 1, ASA 2 status, in the age group of 18-60 years scheduled for elective non-cardiac surgical procedures under general anaesthesia were selected for this prospective randomized controlled study conducted after obtaining institutional approval. They were randomly divided into 3 groups of 50 each. Group C (control group), Group Lignocaine and Esmolol Group. All the patients irrespective of group to which they belonged received tablet diazepam 0.15 mg/Kg the previous night followed by intramuscular Pethidine 1 mg/Kg 1 hour prior to the scheduled surgery.RESULTSIn esmolol group, there has significant attenuation of heart rate, SAP, DAP and mean arterial pressure following laryngoscopy and endotracheal intubation compared to lignocaine group. Lignocaine group has significant attenuation of heart rate, SAP, DAP and mean arterial pressure following laryngoscopy and endotracheal intubation compared to control group.CONCLUSIONSEsmolol hydrochloride given in the dose of 1.5 mg/Kg body weight 3 minutes prior to intubation provided consistent and reliable protection against increase in mean heart rate. SAP, DAP and MAP during laryngoscopy and intubation compared to lignocaine (1.5 mg/Kg).