Background: The process of laryngoscopy and tracheal intubation often triggers a pronounced sympathetic response, leading to transient but marked increases in heart rate and blood pressure. These changes, though short-lived, may pose a significant risk in patients with cardiovascular compromise. Objective: This study was designed to compare the efficacy of intravenous bolus esmolol (2mg/kg) and fentanyl (2µg/kg) in attenuating the hemodynamic responses to laryngoscopy and endotracheal intubation. Methods: Seventy-five ASA I patients scheduled for elective surgical procedures under general anesthesia were randomized into three groups to receive either saline (control), esmolol, or fentanyl prior to induction. Hemodynamic parameters including heart rate, systolic, diastolic, and mean arterial pressure were measured at multiple intervals peri-intubation. Results: The esmolol group showed a statistically significant attenuation of heart rate response post-intubation (p = 0.002) compared to the fentanyl and control groups. Although both study drugs reduced systolic and diastolic pressures, the differences among groups were not statistically significant. Conclusion: Esmolol more effectively attenuates the rise in heart rate associated with intubation than fentanyl and may be the agent of choice for suppressing cardiovascular stress responses during airway manipulation.
Impact Factor
2022: 6.012
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