Affiliations 

  • 1 Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
  • 2 Department of Anaesthesiology and Intensive Care, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Malays J Med Sci, 2021 Jun;28(3):46-55.
PMID: 34285643 DOI: 10.21315/mjms2021.28.3.4

Abstract

Background: This study aims to compare the effect of infusions of two agents, dexmedetomidine and esmolol, with the control group in attenuating the haemodynamic stress response and neuroendocrine modulation surrogated by capillary blood glucose (BG) during the procedures.

Methods: Sixty patients aged 18-70 years old who underwent elective surgeries involving endotracheal intubation were randomised into three groups of equal size: i) control; ii) dexmedetomidine and iii) esmolol. Heart rate (HR) was measured at baseline (T0), after drug administration (T1), after induction of anaesthesia (T2), immediately after intubation (T3), and 3 min, 5 min and 10 min after intubation (T4, T5 and T6). BG was measured pre-operatively and 30 min post-intubation.

Results: Two-way repeated-measures analysis of variance showed significant time [within-group changes, F(3.2, 182.5) = 30.39, P < 0.001], treatment [between-group differences regardless of time, F(2, 57) = 50.24, P < 0.001] and interaction [between-group differences based on time, F(6.4, 182.5) = 37.65, P < 0.001] effects on HR. A significantly higher HR was observed in the control group compared to the dexmedetomidine and esmolol groups from T2 to T6. BG exhibited a significant time effect [F(1, 57) = 41.97, P < 0.001] with no significant treatment and interaction effects. All three groups showed a significant increase in BG from baseline.

Conclusion: Both dexmedetomidine and esmolol are equally effective in attenuating haemodynamic responses to laryngoscopy and intubation. However, both do not significantly modulate neuroendocrine stress.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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