The influence of various esmolol infusion dosages on response to laryngoscopy and tracheal intubation

Objective: To compare the effects of various esmolol infusion dosages on bispectralindex (BIS) values, hemodynamic and movement response to laryngoscopy andtracheal intubation (LTI).Materials and Methods: 120 patients were included in the study, prospectively. Afterpropofol administration, anesthesia was maintained with propofol infusion + 50 % air /O2 mixture. When the patient became unconscious, the sleeve on the arm was inflated50 mmHg over the systolic blood pressure and rocuronium was administered. In the 5thminute of the propofol infusion, 1 mg/kg esmolol was given as the loading dose and thepatients were divided into 3 groups; in Group Es50 50 ?g/kg/min, in Group Es150 150?g/kg/min, in Group Es250 250 ?g/kg/min esmolol infusion was started. Trachealintubation was performed at fifth minute of esmolol infusion. Any movement in 1 minuteObjective: To compare the effects of various esmolol infusion dosages on bispectralindex (BIS) values, hemodynamic and movement response to laryngoscopy andtracheal intubation (LTI).Materials and Methods: 120 patients were included in the study, prospectively. Afterpropofol administration, anesthesia was maintained with propofol infusion + 50 % air /O2 mixture. When the patient became unconscious, the sleeve on the arm was inflated50 mmHg over the systolic blood pressure and rocuronium was administered. In the 5thminute of the propofol infusion, 1 mg/kg esmolol was given as the loading dose and thepatients were divided into 3 groups; in Group Es50 50 ?g/kg/min, in Group Es150 150?g/kg/min, in Group Es250 250 ?g/kg/min esmolol infusion was started. Trachealintubation was performed at fifth minute of esmolol infusion. Any movement in 1 minuteon the sleeved arm of the patient after the intubation was accepted as a positive value.The difference in BIS values, before laryngoscopy and 1 . min following LTI (?BIS) andthe maximum BIS value difference (?BISmax) were recorded. The study was terminatedfive minutes after intubation.Results: There were significant changes in HR following LTI compared to basal valuesin Group Es50 till the end of 4th minute after LTI (p<0.05), no changes at other groups.In comparison to basal values there was a significant increase in MAP values in allgroups one minute following LTI. The movement response to LTI was significantly highin Group Es50 (%87,5) when compared to Group Es250 (%50) and Group Es150 (%56)(p<0.05). ?BIS and ?BISmax values in Group Es50 were significantly higher than theother two groups. Patients didn?t experience adverse effects such as hypotension,bradycardia.Conclusion: It was demonstrated that, in propofol anesthesia administration infusion ofesmolol 250 and 150 ?g/kg/min after 1 mg/kg loading dose, when compared to 50?g/kg/min esmolol, reduced the increase in BIS values, HR and the movementresponse related to LTI.