Introduction:

Investigation of the efficacy of different induction doses of esmolol in prevention of increases of heart rate and mean arterial pressure after endotracheal intubation in both hypertensive and normotensive patient groups.

Material and Method:

Ninety patients aged between 20-65 years were randomized into Group K (Control group n=30), Group N (Normotensive group n=30) and Group H (Hypertensive group n=30). All groups received standard induction with 5-7 mg kg-1 thiopental sodium, 0,1 mg kg-1 vecuronium bromide, control group 5 mL 5 % dextrose i.v, normotensive group 1 mg kg-1 esmolol i.v. and hypertensive group 2 mg kg-1 esmolol i.v within 30 seconds after induction of anesthesia. Systolic (SAP), and diastolic (DAP), mean arterial pressures (MAP) and heart rate (HR) were measured and recorded for all patients at pre-induction, post-induction, post-intubation 1., 3., 5., 7. and 10. minutes.

Results:

MAP values of normotensive group at post-intubation 1. minute were found to be significantly lower than other groups (p<0.05). MAP values of normotensive group at post-intubation 3. and 5. minutes were found to be significantly lower than the control group (p<0,05). There were no significant differences in HRs between groups at basal, pre-induction, post-induction and post-intubation 10. minutes (p>0,05). HR values of the Hypertensive group at post-intubation 1., 3., 5. minutes were found to be significantly lower than the control group (p<0,001).

Conclusion:

Esmolol successfully prevents tachycardia which occurs as a response to intubation especially in hypertensive patients. While esmolol effectively controls arterial pressures of normotensive patients at these abovementionhed doses, they might be insufficient for hypertensive patients.

Keywords: Esmolol, endotracheal intubation, laryngoscopy, cardiovascular responses