Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep;4(3):163-8.
doi: 10.4103/1658-354X.71573.

Comparison of esmolol and labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation

Sarvesh P Singh  1 , Abdul Quadir, Poonam Malhotra
Affiliations

Comparison of esmolol and labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation

Sarvesh P Singh et al. Saudi J Anaesth. 2010 Sep.

Abstract

Objective: The present study compared the efficacy of esmolol and labetalol, in low doses, for attenuation of sympathomimetic response to laryngoscopy and intubation.

Design: Prospective, randomized, placebo controlled, double-blinded study.

Setting: Operation room.

Patients and methods: 75 ASA physical status I and II adult patients, aged 18-45 years undergoing elective surgical procedures, requiring general anesthesia and orotracheal intubation.

Interventions: Patients were allocated to any of the three groups (25 each)-Group C (control)10 ml 0.9% saline i.v. Group E (esmolol) 0.5 mg/kg diluted with 0.9% saline to 10 ml i.v. Group L (labetalol) 0.25 mg/kg diluted with 0.9% saline to 10 ml i.v. In the control group 10 ml of 0.9% saline was given both at 2 and 5 min prior to intubation. In the esmolol group 0.5 mg/kg of esmolol (diluted with 0.9% saline to 10 ml) was given 2 min prior and 10 ml of 0.9% saline 5 min prior to intubation. In the labetalol group 10 ml of 0.9% saline was administered 2 min prior and 0.25 mg/kg of labetalol (diluted with 0.9% saline to 10 ml) 5 min prior to intubation. All the patients were subjected to the same standard anesthetic technique.

Measurements: Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded prior to induction, at time of intubation and 1, 3, 5, and 10 min after intubation. Mean arterial pressure (MAP) and rate pressure product (RPP) were calculated. Abnormal ECG changes were also recorded.

Results: Compared to placebo and esmolol (0.5 mg/kg), labetalol (0.25 mg/kg) significantly attenuated the rise in heart rate, systolic blood pressure, and RPP during laryngoscopy and intubation. However, the difference was not statistically significant among the values for DBP and MAP.

Conclusion: In lower doses, labetalol (0.25 mg/kg) is a better agent than esmolol (0.5 mg/kg) in attenuating the sympathomimetic response to laryngoscopy and intubation.

Keywords: Labetalol; esmolol; intubation; response; sympathomimetic.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Bedford RE, Feinstein B. Hospital admission blood pressure predictor for hypertension following endotracheal intubation. Anesth Analg. 1980;59:367–70. - PubMed
    1. Stoelting RK. Blood pressure and heart rate changes during short duration laryngoscopy for tracheal intubation: influence of viscous or intravenous lidocaine. Anesth Analg. 1978;57:197–9. - PubMed
    1. Martin DE, Rosenberg H, Aukburg SJ, Bartkowski RR, Edwards MW, Jr, Greenhow DE, et al. Low dose fentanyl blunts circulatory responses to tracheal intubation. Anesth Analg. 1982;61:680–4. - PubMed
    1. Stoelting RK. Attenuation of blood pressure response to laryngoscopy and tracheal intubation with sodium nitroprusside. Anesth Analg. 1979;58:116–9. - PubMed
    1. Kamra S, Wig J, Sapru RP. Topical nitroglycerine. A safeguard against pressor response to tracheal intubation. Anaesthesia. 1986;41:1087–91. - PubMed