The Effect of Intravenous Esmolol on Endotracheal Intubation

Lee, Sang Chul; Kim, Hae Kyoung; Ham, Byung Moon

Abstract

Changes in blood pressure(systolic, diastolic and mean arterial pressure) and heart rate were measured during intubation and induction of anesthesia for 5 minutes with isoflurane-N2O-O2 and vecuronium in 40 ASA physical status I patients to assess the effect of three doses of esmolol(Group 1: none, Group 2: 0.5 mg/kg, Group 3: 1 mg/kg, Group 4: 1.5mg/kg, n=10 in each group) giving as a bolus l minute prior to endotracheal intubation. Blood pressure and heart rate showed relatively higher values after intubation in control group(saline-treated group) than other groups. Administration of 1.5 mg/kg of esmolol brought less severe rise(maximum rise 103+/-11 mmHg comparing with 134+/-19 mmHg, 119+/-21 mmHg, and 124+/-17 mmHg in Group 1, 2 and 3, respectively) in systolic pressure comparing with other groups but increase of the dose of esmolol did not cause significant effect on heart rate. The side effects of esmolol did not cause significant effect on heart rate. The side effects of esmolol including hypotension, bradycardia, and rhythm abnormality appeared in esmolol-treated groups and the incidence became higher as the dose of esmolol was increased. We might say that 0.5 mg/kg of esmolol is sufficient to control the vital signs cbanges caused by adrenergic response during endotracheal intubation and, at the same time, we have to pay special attention to the side effects of esmolol.