COMPARISON OF ESMOLOL, CLONIDINE, AND LIGNOCAINE FOR SUPPRESSION OF HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION AS AN ADJUVANT TO FENTANYL IN ADULT PATIENTS UNDERGOING ELECTIVE SURGERY

ABSTRACT

Introduction: Laryngoscopy and endotracheal intubation lead to a strong sympathetic response, this study was done to compare clonidine, esmolol, and lignocaine as an adjuvant to fentanyl to attenuate the pressor response to laryngoscopy during endotracheal intubation. To compare clonidine, esmolol, and lignocaine as an a Objectives: djuvant to fentanyl to attenuate the pressor response to laryngoscopy during endotracheal intubation. A Randomized prospective study includi Material and Methods: ng 150 normotensive patients undergoing elective surgical procedures were included. Three groups were divided according to drug they received. After 3 minutes of drug , laryngoscopy and endotracheal intubation were done. Vitals (HR,SBP,DBP and MAP) were noted before laryngoscopy and endotracheal intubation and 1,2,4,6 and 8 minute after Laryngoscopy and endotracheal intubation and anaesthesia was continued with O2+N2O+Sevoflurane. Results: Rise in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) at one minute following intubation in all three groups of drugs (p<0.001). SBP both esmolol and clonidine reached equal to baseline in 4 mins with their respective p-value as 0.293 and 0.097 and group lignocaine reached equal to baseline in 6 mins. DBP of group esmolol reached baseline at 4 mins (p-value- 0.090), group clonidine reached baseline in 6 mins. And group lignocaine does not reach baseline even after 8 mins. MAP in esmolol group reached to baseline in 4 mins, group clonidine reached to baseline in 6 mins and group lignocaine does not reach to baseline even after 8 mins. Conclusion: Considering all parameters, it was concluded that esmolol with fentanyl showed better response on all parameters.