A Comparative Evaluation of Nitroglycerine and Esmolol in Attenuating the Haemodynamic Response to Laryngoscopy and Intubation

Background: Laryngoscopy and tracheal intubation provoke stress response manifesting as hypertension and tachycardia.There is urgent need for drug which can attenuate the cardiovascular response to the laryngoscopy and intubation.Subjects and Methods: The study was conducted in department of anaesthesia in JNUIMSRC.50 Patients belonging to ASA grade 1 and 2 posted for surgery under general anaesthesia were randomly divided into two groups of 25 each.Premedication with Midazolam and Glycopyrolate was done.Patients were divided randomly in two groups: Group N-Nitroglycerine ointment 2%, 2.5 cm topically applied on forhead, 10 min .priorto induction.Group E-Esmolol 0.6 mg/kg IV 2 min.prior to induction.Both group were induced and laryngoscopy and tracheal intubation was done within 20 sec.Heart rate, blood pressure and mean arterial pressure was recorded before induction and at 1,2,3,5,10 and 15 min after laryngoscopy and intubation.Statistical analysis was done using students 't' test and was considered significant if p < 0.05.Results: Patients in esmolol group remained haemodynamically more stable than nitroglycerine group.Conclusion: In our study it is concluded that Esmolol is more effective than Nitroglycerine in attenuating the haemodynamic response to laryngoscopy and intubation.