European Journal of Cardiovascular Medicine

Introduction: Airway management in elective surgeries is best with endotracheal intubation. Both laryngoscopy and endotracheal intubation produce marked reflex sympathoadrenal stimulation which gives rise to hypertension and tachycardia. These reflex peaks within 1 min and ends in about 5–10 min after intubation which increases complications like myocardial ischemia left ventricular failure, and cerebral haemorrhage especially in patients with cardiovascular disease. Dexmedetomidine is a novel alpha-2 adrenergic agonist which decreases sympathoadrenal response and maintains haemodynamic stability during laryngoscopy and endotracheal intubation. Esmolol is a rapid onset, ultra-short acting, cardioselective beta-1 adrenergic receptor antagonist that possesses little sedative effect, but no analgesic activity and proved to be an effective agent to provide haemodynamic stability during laryngoscopy and endotracheal intubation. In the present study, we compared the effectiveness between Dexmedetomidine and Esmolol for attenuating haemodynamic response to laryngoscopy and endotracheal intubation during surgery under general anaesthesia. Methods: The present study was undertaken from November 2021 - June 2022, among 80 patients undergoing routine surgery under general anaesthesia randomly divided into 2 groups of 40 patients each by using a sealed envelope technique. Group D (Dexmedetomidine): consisting of 40 patients who received Dexmedetomidine 0.5μg/kg in 100ml normal saline, 3 minutes prior to intubation. Group E (Esmolol): consisting of 40 patients who received 1 mg/kg Esmolol, 3 minutes prior to intubation.  Results: There was a statistically significant lower HR, SBP, DBP and MAP in group D compared to group E during laryngoscopy and 1, 3, 5 and 7 minutes after endotracheal intubation. Conclusion: We can conclude that administration of a single dose of dexmedetomidine 0.5 μg/kg i.v. before laryngoscopy was an effective method for attenuating the hemodynamic response to endotracheal intubation compared to a single dose of esmolol 1 mg/kg i.v.