Nikhil Mudgalkar¹, K.Ravinder Reddy², Lanka Siva rama prasad³

¹Associate Professor,Department of Anaesthesiology, ² Professor,Department of General Medicine and Consultant Cardiologist ,³Associate Professor, Department of General Surgery and Consultant Cardiac Surgeon,Prathima Institute of Medical Sciences,Karimnagar,Telangana,India.

Address for correspondence: Dr. Nikhil Mudgalkar, Associate Professor,Department of Anaesthesiology Prathima Institute of Medical Sciences,Karimnagar,Telanagana,India.

Email: drniks200@yahoo.com

Introduction: Laryngoscopy and intubation are associated with massive hemodynamic changes which can be detrimental to patients with cardiac disease. Very few studies tried to compare Dexmedetomidine and Esmolol for prevention of this response in off pump coronary artery disease. The designs of the study are biased towards one agent as these two drugs have to be given by different forms. We tried to compare these two agents with different design so as to take advantage of most appropriate dosage form.

Material and Methods:The present study is a prospective, double blind, parallel group, randomized study done on eighty patients divided in two groups. After randomization, patients received Dexmedetomidine 0.5 microgram/kg vs. Esmolol 2 mg/kg. Anaesthesia was induced in routine manner after invasive monitoring. Blood pressure, heart rate were assessed prior to induction and at the time of induction,1 min,3 min,5 min and 10 minute post induction and intubation.

Results: Demographic characters were comparable in both the groups with non significant p values. Both the drugs controlled heart rate, systolic blood pressure and diastolic blood pressure well in first 3 minutes indicating effectiveness. Dexmedetomidine scored over Esmolol after 3rd minute and prevented the heart rate and blood pressure from rising in a sustained manner even at 10th minute.

Conclusion: Dexmedetomidine and Esmolol are appropriate for attenuation of hemodynamic control in off pump coronary artery bypass patients for up to 3rd minute. Dexmedetomidine provides more sustained hemodynamic stability up to 10th minute and suitable for long term control.

Keywords :Dexmedetomidine, Esmolol,intubation, coronary artery bypass grafting