Comparison of Esmolol and Dexmedetomidine Infusion in Attenuating Haemodynamic and Blood Glucose Response to Laryngoscopy and Intubation: A Single Blinded Study

• Published in: The Malaysian journal of medical sciences 2021-05, Vol.28 (3), p.46-55
• Main Authors: Koh, Vincent, Ali, Saedah, Hassan, Mohamad Hasyizan, Mokhtar, Ariffin Marzuki, Yaacob, Mohd Najib Majdi, Mazlan, Mohd Zulfakar
• Format: Article
• Language: English
• Subjects: Anesthesia; Blood pressure; Drug dosages; Fentanyl; Glucose; Heart rate; Intubation; Laryngoscopy
• ISSN: 1394-195X; 2180-4303
• DOI: 10.21315/mjms2021.28.34

Keywords: dexmedetomidine, laryngoscopy, intubation, haemodynamic response neuroendocrine stress Introduction Laryngoscopy and tracheal intubation can lead to a profound sympathetic response, which has few consequences in healthy subjects but may result in unpredictable adverse effects such as arrhythmias, myocardial ischaemia, left ventricular failure, increased intracranial pressure or ruptured cerebral aneurysms in susceptible populations. (2) concluded that the usual 2.0 pg/kg dose of fentanyl was unable to reduce the haemodynamic response to laryngoscopy and intubation, as the increase in systolic blood pressure (SBP) was 13.23%, diastolic blood pressure (DBP) was 9.42%, mean arterial pressure (MAP) was 12.78% and heart rate (HR) was 11.62% from baseline. A recent study using blood glucose (BG) estimation as an indirect surrogate of neuroendocrine stress has been conducted and assessed its modulation by dexmedetomidine or fentanyl during laparoscopic surgery (8), revealing a positive result. [...]the study was mainly designed to assess responses to surgical stress or stimuli. [...]the current study's primary aim was to compare the effects of esmolol and dexmedetomidine infusions in attenuating the sympathetic stress response and modulating the neuroendocrine stress response to laryngoscopy and tracheal intubation.