Effects of Esmolol on Hemodynamic Responses to Laryngoscopy and Tracheal Intubation in Diabetic Versus Non-Diabetic Patients

Authors: TANER TAŞYÜZ, İSMET TOPÇU, SABRİ ÖZASLAN, MELEK SAKARYA

Abstract: Aim: We aimed to investigate the efficiency of esmolol, a short-acting ß-blocker, in preventing the hemodynamic response to laryngoscopy and endotracheal intubation in diabetic patients. Materials and Methods: Eighty diabetic or non-diabetic patients with ASA physical status I-II scheduled for noncardiac surgery were included in this study. They were divided randomly into 4 groups (Non-diabetic control: NDC, Non-diabetic esmolol: NDE, Diabetic control: DC, Diabetic esmolol: DE). Blood glucose analyses were measured in the preoperative period and at the 10^{th} min of the study. Prior to anesthetic induction, 1 mg/kg esmolol to Groups NDE and DE and saline to Groups NDC and DC were administered in 1 min by slow infusion. After 2 mins, systolic and diastolic arterial blood pressures (SBP, DBP), heart rate (HR), bispectral index (BIS) and peripheral oxygen saturation (SpO_2) were recorded in all groups. Laryngoscopy and endotracheal intubation were performed after induction. SBP, DBP, HR, SpO_2 and BIS values were recorded every minute during 10 mins after intubation. Results: In Groups NDE and DE, SBP, DBP and HR values were significantly lower after drug administration than the values obtained before drug administration (p<0.05). In Groups NDC, NDE and DC, SBP, DBP and HR values were significantly higher in the first minute of the intubation compared to before drug administration (p<0.05), but were significantly low in subsequent measurements (p<0.05). Blood glucose analyses were found significantly higher in Group NDE than Group NDC (p<0.05). Conclusions: We propose that esmolol might be used effectively to control hemodynamic response to tracheal intubation in diabetic patients. We also determined that esmolol causes no difference in blood glucose levels.

Keywords: Esmolol, laryngoscopy, intubation, diabetics

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