title: Prospective randomized study to compare between intravenous dexmedetomidine and esmolol for attenuation of hemodynamic response to endotracheal intubation.
abstract: BACKGROUND
  Esmolol has an established role in attenuation of hemodynamic response to laryngoscopy and endotracheal intubation. We studied the effect of dexmedetomidine compared to that of esmolol in this study.
  
  
  OBJECTIVE
  To study the role of dexmedetomidine in attenuation of hemodynamic response to laryngoscopy and oral endotracheal intubation compared to that of esmolol hydrochloride in patients posted for elective surgery under general anesthesia.
  
  
  METHODS
  Prospective randomized study double-dummy blinding method.
  
  
  METHODS
  A total of 60 American Society of Anesthesiologists I patients, aged 18-60 years randomly divided into two groups; Group A patients received dexmedetomidine 1 mcg/kg diluted in 50 ml with normal saline and infused over 10 min before induction and also 20 ml of normal saline intravenous (IV) 2 min before endotracheal intubation. Group B patients received 50 ml IV infusion of normal saline over 10 min before induction and IV bolus of esmolol 0.5 mg/kg diluted in 20 ml with normal saline given 2 min before intubation. Standard induction technique followed. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded just before induction and after intubation at 1 min, 3 min, and 5 min after intubation.
  
  
  METHODS
  Independent samples t-test and repeated measures of analysis of variance.
  
  
  RESULTS
  Dexmedetomidine group showed statistically significant reduction in all the study parameters at all study time intervals following intubation. While esmolol group showed significant attenuation of HR, SBP, and MAP following intubation but failed to produce significant reduction in DBP.
  
  
  CONCLUSIONS
  Dexmedetomidine is more effective in attenuating the hemodynamic response to oral endotracheal intubation compared to that of esmolol hydrochloride.
authors.affiliation: Department of Anaesthesiology, Critical Care and Pain Medicine, Sri Ramachandra Medical College and Research Centre, Porur, Chennai, Tamil Nadu, India.
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Selvaraj
authors.affiliation: Department of Anaesthesiology, Critical Care and Pain Medicine, Sri Ramachandra Medical College and Research Centre, Porur, Chennai, Tamil Nadu, India.
authors.forename: Karthik Raj
authors.initials: KR
authors.lastname: Manoharan
keywords: Blood pressure; dexmedetomidine; esmolol; heart rate; intubation