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Volume 12 Issue 3 ( July-September ) 2023

Original Articles

Attenuation of pressor response to laryngoscopy and intubation with I.V. Magnesium Sulphate and I.V. Esmolol – A comparative study
Dr Deepanjana Ghosh, Dr Soumen Mandal, Dr Susmita Chakraborty, Dr Kajal Kumar Patra, Dr Kishore P Madhwani

Introduction: The larynx, pharynx, and trachea are directly stimulated during a standard laryngoscopy and intubation procedure. These structures are highly innervated by the autonomic nervous system, specifically the parasympathetic innervation via the vagus and glossopharyngeal nerves and the sympathetic innervation via the superior cervical ganglion. Aim: The aim of the present study was to compare the effects of magnesium sulphate and esmolol in. reducing the pressor effects to laryngoscopy and intubation based on the basis of heart rate changes from the baseline values. Materials and Methods: The present hospital based prospective comparative observational study was conducted in Nil Ratan Sircar Medical college and hospital, Kolkata, West Bengal, India between February 2020 to August 2021. Informed consent of 88 patients of both sexes who were scheduled for elective urosurgical procedures under general anesthesia were included in the study based on the inclusion and exclusion criteria. Software such as SPSS V.24 and Microsoft Excel were used to analyze statistical data. Results: The mean age in years and mean BMI in kg/m2 were similar in two Groups. The baseline mean HR was 96.8 +/-18.9 beats/min and 103.1 +/- 20.7 bpm in group A and group B respectively. This showed that the basal heart rate in the two groups was not significantly different from each other. The baselinemean systolic BP in group A and group B were 125.1 +/- 9.3 mmHg and 122.6 +/- 15.3 mmHg respectively. Hence the P value was 0.391 which was statistically insignificant. Mean diastolic blood pressure in mmHg with standard deviation at different time intervals. The baseline DBP were 85.9 +/- 4.0 mmHg in group A and 80.1 +/- 3.9 mmHg in group B which was statistically insignificant. hypotension was found in either of the group but that was comparable, hence as per the study design adverse reaction which was observed intraoperatively and till 1 hr post-operative period was insignificant. Conclusion: In this study it was concluded that considering the changes of decrease in mean heart it was found that administration of esmolol was better than magnesium sulphate to prevent pressor response following laryngoscopy and tracheal intubation.

 
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