An Observational Study To Compare Three Bolus Doses Of Esmolol For Attenuation Of Stress Response To Intubation And Laryngoscopy In Patients Undergoing General Anaesthesia

Abstract

Background

Endotracheal intubation is a commonly performed procedure in anaesthesia, but it can cause significant hemodynamic changes such as increased blood pressure, heart rate, and myocardial oxygen demand. Esmolol has been shown to effectively attenuate these changes, but the optimal dose for this effect is not well established.

Method

The observational study was conducted at the Department of Anaesthesiology in Dhiraj Hospital for a duration of 6 months. Sixty patients were randomly assigned to receive one of three doses of esmolol: 0.5 mg/kg, 1 mg/kg, or 1.5 mg/kg with 20 in each group. Hemodynamic parameters including pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured at baseline, during intubation, and at 1, 3, 5, and 10 minutes after intubation. Parametric and non-parametric tests were used to assess the significance level between variables.

Result

A female predominance was seen with 60.0% of females whereas 35.85±8.60 was the mean age of patients. No significant difference was reported between age, gender, and weight when compared with the esmolol groups. A significant difference was observed during intubation, 1 min, 3 min, 5 min and 10 min post-intubation for pulse rate, SBP, DBP, and MAP levels (p-value <0.001). Esmolol in a dose of 1.5 mg/kg has been reported to be most effective due to consistent lowering of pulse, BP, and MAP.

Conclusion

In conclusion, this study suggests that esmolol can effectively reduce the hemodynamic response to endotracheal intubation, and the optimal dose for this effect is 1.5 mg/kg. These findings may have important clinical implications for reducing perioperative morbidity and mortality.