An Observational Study to Compare the Efficacy of Intravenous Esmolol for Attenuation of Pressor Response during Laryngoscopy and Endotracheal Intubation

Background: Laryngoscopy as well as d endotracheal intubation are standard measures during anesthesia but are frequently linked to significant cardiovascular outcomes like as elevated heart rate (HR) and blood pressure (BP). Numerous pharmacological agents have been employed to mitigate these hemodynamic fluctuations. Esmolol, a short-acting β1-selective adrenergic blocker, has shown potential in minimizing the pressor effects associated with these procedures. Objective: The objective of this study was to assess the effectiveness of intravenous esmolol in reducing the pressor response during laryngoscopy and endotracheal intubation in patients scheduled for elective surgeries. Methods: This prospective observational study was conducted at SKMCH, Muzaffarpur, over a one-year period. The study included 100 patients aged 18 to 60 years undergoing elective surgeries. The primary goal was to compare the effectiveness of intravenous esmolol in attenuating the hemodynamic response during laryngoscopy and intubation. Heart rate and blood pressure were continuously monitored before and after intubation. Data analysis was performed using SPSS version 21.0, with statistical significance evaluated through t-tests and chi-square tests. Results: Intravenous esmolol significantly decreased both heart rate and blood pressure in patients during and after laryngoscopy and intubation, as compared to the control group. At 1, 3, and 5 minutes post-intubation, patients in Group A (esmolol) exhibited notably lower heart rates and systolic/diastolic blood pressures (p < 0.05). There were no significant changes in oxygen saturation, and no adverse effects attributed to esmolol were observed. These findings indicate that esmolol effectively blunts the pressor response during intubation. Conclusion: Esmolol administered intravenously is an effective agent for reducing the pressor response during laryngoscopy and endotracheal intubation, enhancing hemodynamic stability in patients under general anesthesia. This may be particularly advantageous for individuals with elevated cardiovascular risk. Recommendations: Routine use of esmolol in elective surgeries involving endotracheal intubation is recommended, especially for patients prone to cardiovascular complications. Further research comparing esmolol with other beta-blockers or exploring its combination with different pharmacological agents is suggested to optimize control of hemodynamic parameters during anesthesia.