Comparision of Esmolol and Labetalol in Low Doses for Attenuation of Sympathomimetic Response to Laryngoscopy and Intubation
Author(s): Joshua Dhavanam Y, Ramlal Porika* and Kommuri Sudha
Abstract
Background and aims: Sympathoadrenal response to direct laryngoscopy and tracheal intubation invariably results in increases in heart rate and elevation in mean arterial pressure. In some instances arrhythmias can be precipitated. These potentially harmful responses may prove to be detrimental in patient at risk. Many techniques and various drugs have been employed to attenuate these haemodynamic responses. No single drug or technique is totally satisfactory. Thus there is a need to find a simple efficient and reliably consistent method.
Materials and methods: Prospective, randomized, controlled, single blinded trial comparing two adrenergic antagonists labetalol (nonselective) and esmolol (B1 selective) in decreasing the pressure response during rigid laryngoscopy and intubation in 90 patients of both sex, who belong to ASA -I &ASA-II of age group 18-55 years , from 2015-2016. Prospective, randomized, controlled, single blinded trial compares two adrenergic antagonists labetalol (nonselective) and esmolol (B1 selective) done by randomly allocating into three groups.
Results: In the control group heart rate, systolic, diastolic and mean arterial blood pressures showed wide fluctuation, a maximal increase at the time of intubation and returned gradually to basal values over 10 minutes. In Labetalol group significant suppression of heart rate and blood pressure was observed when compared to control group which returned to baseline at the end of 10min. whereas low dose esmolol (0.5 mg/kg) is inferior to that of labetalol for the same purpose.
Conclusion: In lower doses, labetalol is a better agent than esmolol in attenuating the sympathomimetic response to laryngoscopy and intubation whereas low dose esmolol is inferior to that of labetalol.