Comparing the Efficacy of Esmolol and Lignocaine for Attenuating the Pressor Response during Laryngoscopy and Endotracheal Intubation

Introduction: The Pressor response characterized by tachycardia and hypertension following laryngoscopy and intubation is well-recognized, which can be hazardous in patients with cardiovascular disease as it may precipitate arrhythmias, myocardial ischemia and cerebrovascular accidents. Various techniques are currently employed to attenuate this response but so far, none have been proven to be superior .This study was conducted to compare the efficacy of Esmolol and Lignocaine in attenuating the Pressor Response to laryngoscopy and intubation. Material and Methods: A cross sectional analytical study was conducted on 52 patients aged between 20-50 years belonging to ASA I and II scheduled for surgery under general anaesthesia after obtaining clearance from hospital ethical committee and informed consent from patients. Group (E) received 2mg.kg-1 of esmolol IV 2 minutes before intubation and Group (L) received 2 mg kg-1 of lignocaine 2 minutes before intubation. Haemodynamic parameters such as Heart rate, Systolic BP, Diastolic BP and MAP was compared between the two groups at induction and 1, 3, 5 minutes post induction. Results: The demographic data was comparable between both the groups. There was a significant increase in mean HR in lignocaine group during laryngoscopy and intubation, which did not come back to baseline level even after 5 min (p value of 0). In the esmolol group, there was a significant attenuation of HR during intubation and 1, 3, 5 minutes following intubation. MAP was better controlled in esmolol group compared to lignocaine. Conclusion: Esmolol was proven to be more effective in controlling the pressor response during laryngoscopy and intubation when compared to lignocaine.