A Comparative Study on the Effects of Intravenous Esmolol, Fentanyl and Lignocaine on Attenuation of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation

Abstract

This study was conducted to assess the effectiveness and compare the effects of intravenous lignocaine, fentanyl, and esmolol on the reduction of the hemodynamic response to endotracheal intubation and laryngoscopy.

Methods

After receiving approval from the institutional ethics committee and signed informed consent from the study participants, a prospective comparative study based in a hospital was carried out among 267 patients who underwent elective non-cardiac surgeries at the Department of Anaesthesiology, Government Medical College, Thrissur, between January 2020 and January 2021.

Results

Heart rate, systolic and diastolic blood pressure, and mean arterial pressure were measured before premedication (baseline), before drug infusion, during laryngoscopy and intubation, and at 1, 3, 5, and 10 minutes following laryngoscopy and intubation. During laryngoscopy and intubation, the hemodynamic response was attenuated in all three groups (esmolol, lignocaine, and fentanyl). Of these, esmolol demonstrated a significant reduction in heart rate, while fentanyl demonstrated a significant reduction in blood pressure during and for up to 10 minutes following laryngoscopy and intubation.

Conclusion

The study's findings also show that, when administered prior to the procedure, intravenous fentanyl and esmolol are more effective than preservative-free intravenous lignocaine at reducing the pressor response to laryngoscopy and intubation. Fentanyl has a greater impact on lowering mean, diastolic, and systolic blood pressure than esmolol does on heart rate reduction.