Comparison of the efficacy of esmolol and labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation.

Objective: The present study compared the efficacy of esmolol and labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation. Design: Prospective, randomized, double-blinded study. Setting: Operation room. Patients and Methods: 60 ASA physical status I and II adult patients, aged 18-45 years undergoing elective surgical procedures, requiring general anesthesia and endotracheal intubation. Interventions: Patients were allocated to any of the two groups (30 each)- Group E (esmolol) 0.5 mg/kg diluted with 0.9% saline to 10 ml i.v. Group L (labetalol) 0.25 mg/kg diluted with 0.9% saline to 10 ml i.v. 5 min prior to intubation. All the patients were subjected to the same standard anesthetic technique. Measurements: Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded prior to induction, at time of intubation and 1, 3, 5,7, 10, 20, 30,40min after intubation. Mean arterial pressure (MAP) and rate pressure product (RPP) were calculated. Abnormal ECG changes were also recorded. Results Esmolol (0.5 mg/kg), labetalol (0.25 mg/kg) significantly attenuated the rise in heart rate, systolic blood pressure, and RPP during laryngoscopy and intubation. Conclusion: In lower doses Esmolol and Labetalol both effectively blunts the hemodynamic response to endotracheal intubation in patients undergoing surgical procedures under general anesthesia and can be safely used at induction of general anesthesia. We found that labetalol attenuate the pressor response to laryngoscopy and intubation more than esmolol. [ABSTRACT FROM AUTHOR]