Düşük Doz Esmolol: Normotansif Hastalarda Endotrakeal Entübasyona Hemodinamik Yanıt

Authors : Suresh LAKSHMANAPPA, Venkatesh G SURYANARAYANA, Ashley ALORE, Sathees B CHANDRA

Pages : 69-76

View : 61 | Download : 10

Publication Date : 2012-06-01

Article Type : Other Papers

Abstract :Abstract Purpose: Endotracheal intubation is a frequently utilized and highly invasive component of anesthesia that is often accompanied by potentially harmful hemodynamic pressor responses. The purpose of this study was to investigate the efficiency of a single pre-induction 1 mg/kg bolus injection of esmolol for attenuating these hemodynamic responses to endotracheal intubation in normotensive patients. Material and methods: The study was composed of 100 randomly selected male and female patients between the ages of 18 and 60 that were scheduled for elective surgery and belonged to ASA grade I or II. Two minutes prior to intubation the control group received 10 mL of saline insert ignore into journalissuearticles values(n=50); and the experimental group received an injection of esmolol 1 mg/kg diluted to 10 mL insert ignore into journalissuearticles values(n=50);. Heart rate insert ignore into journalissuearticles values(HR);, systolic blood pressure insert ignore into journalissuearticles values(SBP);, diastolic blood pressure insert ignore into journalissuearticles values(DBP);, mean arterial pressure insert ignore into journalissuearticles values(MAP);, and rate pressure product insert ignore into journalissuearticles values(RPP); were compared to basal values before receiving medication insert ignore into journalissuearticles values(T-0);, during pre-induction insert ignore into journalissuearticles values(T-1);, induction insert ignore into journalissuearticles values(T-2);, intubation insert ignore into journalissuearticles values(T-3);, and post-intubation at 1 insert ignore into journalissuearticles values(T-4);, 3 insert ignore into journalissuearticles values(T-6);, 5 insert ignore into journalissuearticles values(T-8);, and 10 insert ignore into journalissuearticles values(T-13); minutes. Results: Esmolol significantly attenuated the hemodynamic responses to endotracheal intubation at the majority of measured points. Attenuation of HR insert ignore into journalissuearticles values(10.8%);, SBP insert ignore into journalissuearticles values(7.04%);, DBP insert ignore into journalissuearticles values(3.99%);, MAP insert ignore into journalissuearticles values(5%);, and RPP insert ignore into journalissuearticles values(16.9%); was observed in the esmolol group when compared to the control group values. Conclusions: A single pre-induction 1 mg/kg bolus injection of esmolol successfully attenuated the hemodynamic pressor response in normotensive patients. A significant attenuation of heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure was observed at the majority of measured time points in the esmolol administered group compared to the control group.
Keywords : Esmolol, endotracheal intubation, hemodynamic response, attenuation

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