Volume : 7, Issue : 4, April - 2018

EFFECT OF INJ. ESMOLOL AND INJ. FENTANYL ON HAEMODYNAMIC CHANGES DURING LARYNGOSCOPY &TRACHEAL INTUBATION- A COMPARATIVE STUDY

Dr Abhay Raj Yadav, Dr Neelesh Nema, Dr Aditya Agarwal

Abstract :

<p class="MsoNormal"><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:black"><span style="mso-spacerun:yes">&nbsp;</span>Aim and objectives: </span></b><b style="mso-bidi-font-weight:normal"><span style="font-size:16.0pt;line-height:&#10;115%;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-bidi-font-family:Calii;&#10;mso-bidi-theme-font:minor-latin;color:black"><o:p></o:p></span></b></p> <p class="MsoNormal" style="margin-right:.5in;line-height:normal"><span style="font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">1)<span style="mso-spacerun:yes">&nbsp; </span>To evaluate the effects of <span style="color:black;background:white;mso-bidi-font-weight:bold">Esmolol and Fentanyl</span>on haemodynamic changes during Laryngoscopy and tracheal intubation.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:.5in;line-height:normal"><span style="font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">2) To compare<span style="mso-spacerun:yes">&nbsp; </span>the effect of </span><span style="font-size:10.5pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;color:black;&#10;background:white;mso-bidi-font-weight:bold">Esmolol and Fentanyl</span><span style="font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">onhaemodynamic changes during Laryngoscopy and tracheal intubation.<span style="mso-spacerun:yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><o:p></o:p></span></p> <p class="MsoNormal" style="margin-right:.5in;line-height:normal"><span style="font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">3) To compare the side effects</span><span style="font-size:14.0pt">.<o:p></o:p></span></p> <p class="MsoNormal"><b><i style="mso-bidi-font-style:normal"><u style="text-underline:white"><span style="font-size:12.0pt;line-height:115%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-hansi-font-family:Calii;mso-hansi-theme-font:&#10;minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi">Materials &amp; Methods</span></u></i></b><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p></o:p></span></b></p> <p class="MsoNormal" style="background:white;mso-background-themecolor:background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><span style="mso-spacerun:yes">&nbsp;</span>This prospective observational study was conducted on 80 patients of ASA Grade I &amp;II ,</span><span style="font-size:&#10;12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;color:black"> undergoing elective surgeries under general anesthesia.</span><span style="font-size:12.0pt;line-height:115%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p></o:p></span></p> <p class="MsoNormal" style="background:white;mso-background-themecolor:background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">GroupA:Injection Esmolol 2 mg/kg i.v. 3 min before laryngoscopy andintubation, over 30 seconds.<o:p></o:p></span></p> <p class="MsoNormal" style="background:white;mso-background-themecolor:background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Group B;Injection Fentanyl 2 &mu;g/kg i.v. 3 min before laryngoscopy andintubation, over 30 seconds.<o:p></o:p></span></p> <p class="MsoNormal" style="background:white;mso-background-themecolor:background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">All patient received Inj. Pentazocine 0.3mg/kg and were pre-oxygenated for 3min. Anaesthesia was induced with thiopantone sodium (5mg/kg IV) till loss of eyelashreflex over 30 second and mask ventilation was confirmed. Injsucchinylcholine 1.5mg/kg was given to facilitate laryngoscopy and intubation. anaesthesia was maintained with oxygen nitrous oxide ,halothane with intermittent use of inj. Atracurium and controlled ventilation.<o:p></o:p></span></p> <p class="MsoNormal" style="background:white;mso-background-themecolor:background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">At the end of surgery the neuromuscular blockade was antagonized with inj. Glycopyrolate (.01mg/kg)I.V.and inj. Neostigmine(.05mg/kg)i.v. and patient were extubated.<o:p></o:p></span></p> <p class="MsoNoSpacing" style="line-height:115%;tab-stops:99.0pt"><b style="mso-bidi-font-weight:normal"><span style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-hansi-font-family:Calii;&#10;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:&quot;Times New Roman&quot;;&#10;mso-bidi-theme-font:minor-bidi">RESULT<o:p></o:p></span></b></p> <p class="MsoNoSpacing" style="line-height:115%;background:white;mso-background-themecolor:&#10;background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:black;background:white">Esmolol</span><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> is more effective than Fentanyl in attenuation of haemodynamic changes during<span style="mso-spacerun:yes">&nbsp; </span>laryngoscopy and intubation.<o:p></o:p></span></p> <p class="MsoNoSpacing" style="line-height:115%;background:white;mso-background-themecolor:&#10;background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p>&nbsp;</o:p></span></p> <p class="MsoNoSpacing" style="line-height:115%;background:white;mso-background-themecolor:&#10;background1"><b style="mso-bidi-font-weight:normal"><span style="font-size:&#10;12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;mso-hansi-font-family:Calii;mso-hansi-theme-font:minor-latin;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-bidi-theme-font:minor-bidi;&#10;color:black">CONCLUSION</span></b><span style="font-size:12.0pt;line-height:&#10;115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"><o:p></o:p></span></p> <p class="MsoNormal" style="background:white;mso-background-themecolor:background1"><span style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:black;background:white">Esmolol</span><span style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> significantly attenuates the haemodynamic changes during<span style="mso-spacerun:yes">&nbsp; </span>laryngoscopy and intubation. Fentanyl also significantly attenuates the haemodynamic changes during laryngoscopy and intubation.Thus we conclude that <span style="color:black;background:white">Esmolol</span>is a better drug to attenuate the haemodynamic response during laryngoscopy and intubation.<o:p></o:p></span></p>