Prospective Randomized Study Comparing the Usefulness of Dexmedetomidine versus Esmolol in Blunting Hemodynamic Responses to Intubation in Surgical Patients

BACKGROUND: Sympathetic response due to laryngoscopy and endotracheal intubation though transient, could be life-threatening in patients with underlying cardiovascular diseases. AIM OF THE STUDY: The aim of this study is to assess the effects of dexmedetomidine and esmolol on the hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing general anesthesia for elective surgery. SETTINGS AND DESIGN: Prospective, randomized study conducted in a tertiary care center. MATERIALS AND METHODS: Sixty patients were recruited and randomly divided into two groups. Group A received 0.5 mcg.kg(−1) dexmedetomidine and Group B 0.5 mg.kg(−1) esmolol infusions over 10 min. All patients were induced with propofol 2 mg.kg(−1) followed by succinylcholine 2 mg.kg(−1) and intubated. The heart rate (HR) and mean arterial pressure (MAP) were recorded at different time points. STATISTICAL ANALYSIS USED: Chi-square test, independent sample t-test, and paired t-test. RESULTS: Baseline HR was statistically different in both groups. There was significant decrease in percentage change in baseline HR in Group A compared to Group B at preinduction (20.44% ± 10.82%, 13.63% ± 11.84%), before intubation (23.49 ± 12.62, 13.95 ± 14.86), and 7 min after intubation (14.65 ± 12.62, 6.80 ± 16.11). Percentage change in HR remained comparable in all other time points. Baseline MAP was comparable between the groups. Percentage change from baseline of MAP was significantly higher in Group B before intubation. All other time points MAP were comparable. The incidence of hypotension was comparable in both groups. CONCLUSIONS: Both dexmedetomidine and esmolol suppressed the hemodynamic response to laryngoscopy and intubation, but dexmedetomidine was more effective than esmolol in maintaining hemodynamic stability.