Comparison of the Clinical Efficacies of Fentanyl, Esmolol and Lidocaine in Preventing the Hemodynamic Responses to Endotracheal Intubation and Extubation

Habib Bostan, Ahmet Eroglu


Background: We compared the efficacy of intravenous fentanyl, esmolol and lidocaine in preventing hemodynamic response to laryngoscopy, endotracheal intubation and extubation in abdominal surgeries.

Methods: A hundred and twenty patients (aging from 18 to 65, ASA class I or II, Mallampati grade I) were randomly divided into 4 groups. Fentanyl 1µg kg-1 (n = 30), Esmolol 1 mg kg-1 (n = 30), Lidocaine 1 mg kg-1 (n = 30) and NaCl 0.9% 10 mL (Control group, n = 30) were administered before induction and extubation. Heart rate, systolic arterial pressure and diastolic arterial pressure were recorded before anesthesia induction and at laryngoscopy, at 1st, 3rd ,5th and 10th minutes of intubation, and then at the end of surgery before extubation, and at 1st, 3rd, 5th, and 10th minutes following extubation. Amounts of the administered drugs and side effects were recorded.

Results: The heart rates and the arterial blood pressures values of the study groups after intubation and extubation were lower than those in the control group (P < 0.01). The heart rates, the systolic and diastolic arterial blood pressure values after intubation and extubation at 1st, 3th, and 5th minutes were significantly lower in esmolol group when compared to fentanyl and lidocaine groups (P < 0.05). In all other measurement times, there was no any different of hemodynamic among the three groups.

Conclusion: When administered before induction and emergency of anesthesia 1 mg kg–1of esmolol and lidocaine, and 1µg kg-1 of fentanyl are effective in suppressing the hemodynamic response to laryngoscopy, intubation and extubation. Esmolol may be more effective to prevent those responses comparing fentanyl and lidocaine. Furthermore studies regarding the dose of those drugs should be required.



Hemodynamic response; Intubation; Extubation; Esmolol; Lidocaine; Fentanyl

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