Esmolol Versus Labetalol For Attenuation Of Hemodynamic Response Associated With Laryngoscopy And Intubation In Elective Surgeries Under General Anaesthesia: A Randomized Comparative Trial

Introduction: Laryngoscopy and endotracheal intubation following induction of anesthesia is associated with hemodynamic changes due to reflex sympathetic discharge. Present study aimed to compare the effect of low dose labetalol and esmolol on sympathomimetic response to laryngoscopy and endotracheal intubation in normotensive patients undergoing surgeries under general anaesthesia.Material and Methods: This Randomized comparative interventional study included a total of 60 patients aged 20 to 50 years, ASA grade I & II, undergoing various elective surgeries under general anesthesia. Eligible subjects were randomized to receive either Esmolol 0.5mg / kg (Group E) or Labetalol 0.25 mg/kg (Group L),  diluted with 0.9% saline to 10 ml intravenously 3 minutes prior to induction. Hemodynamic parameters were noted till 10 minutes after intubation. Results: The Pulse Rate and systolic blood pressure were significantly less in Group L throughout the study time as compared with group E. In DBP and MAP there was no significant difference seen between group E and group L. Both the study groups had increase in Rate Pressure Product after intubation but increase in RPP in Group L were significantly lower than Group E. Hypertension occurred more in Group E as compared to Group L (20% vs 3%; p=0.108). Similarly tachycardia occurred more in Group E as compared to Group L (12% vs 3%; p=0.203). Hypotension, bradycardia or respiratory distress did not occur in any patient. Conclusion: Intravenous dose of Labetalol (0.25mg/kg) and Esmolol (0.5 mg /kg) given 3 minute prior to laryngoscopy and intubation is safe and effective prophylactic method for attenuating hemodynamic response to laryngoscopy and intubation.