COVID-19 Update - This is to inform you that the Government of India has announced a complete lockdown in India 22nd March 2020 to 14th April 2020. As a result, our offices will now be closed till 14th April 2020 and all our employees will be working from home. Office telephones will not be answered, and therefore you are requested to direct all your queries related to manuscript submission, review process, publication etc. at below mentioned details.,, Mob. 8826373757, 8826859373, 9910947804

Article view: 385

Article download: 165

Indian Journal of Clinical Anaesthesia

Attenuation of haemodynamic responses of laryngoscopy and endotracheal intubation: An evaluation of efficacy of single intravenous dose of esmolol hydrochloride

Full Text PDF Share on Facebook Share on Twitter

Author Details : Satyendra Yadav*, R S Verma

Volume : 6, Issue : 1, Year : 2019

Article Page : 40-46

Suggest article by email


Mitigating stress responses of laryngoscopy and endotracheal intubation is critical in management of general anesthesia patient undergoing surgical intervention. This becomes particularly detrimental and critical in patients with hypertension and cardiovascular cerebral disease affecting immediate and long-term outcomes. Role of beta blockade remained limited due to long duration, irreversibility and rebound withdrawal in acute care settings; which led to discovery of cardioselective short acting esmolol hydrochloride (t1/2- 2.5 to 9 min). In this randomized controlled double-blind prospective trial, we studied intravenous esmolol hydrochloride in 2 different single intravenous bolus doses (Group I - control, Group II - 1mg/Kg, Group III- 1.5mg/kg) in ASA 1 and 2 elective normotensive patients. Statistical analysis was done by using paired-t test. Study concluded that esmolol HCL pretreatment after induction with Thiopental Na before laryngoscopy and intubation allowed unique titration of esmolol doses and monitoring of side effects like bradycardia and hypotension and at the same time significantly attenuated sympatho-adrenal response of rise in pulse, mean arterial pressure (MAP), rate pressure product (RRP) and arrhythmia. Esmolol acts differently in different doses. In 1mg/Kg it effectively controls (P<.001) post intubation rise in pulse. Higher dose of 1.5mg/kg is required to control (P<.001) MAP. Rate pressure product is attenuated in group II (P<.01) and group III (P<.001), indicating that esmolol effectively reduces oxygen consumption by heart and likely prevents ischemia in vulnerable patients. Bradycardia of transient nature is seen in some patients in both test groups, reversed by reducing halothane without any treatment. Perioperative side effects like hypotension and bronchospasm that require stopping the test drug esmolol, were not seen in any of test groups, indicating safety of esmolol in such settings.

Keywords: Anaesthesia, Laryngoscopy endotracheal intubation, Cardiovascular response, Attenuation, Esmolol, Efficacy.

Doi : 10.18231/2394-4994.2019.0009

How to cite : Yadav S, Verma R S, Attenuation of haemodynamic responses of laryngoscopy and endotracheal intubation: An evaluation of efficacy of single intravenous dose of esmolol hydrochloride. Indian J Clin Anaesth 2019;6(1):40-46

Copyright © 2019 by author(s) and Indian J Clin Anaesth. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (