Abstract :
Background: Tracheal extubation is associated with a 10–30% increase in arterial pressure and heart rate
that could be detrimental in patients with hypertension, ischemic heart disease, and cerebrovascular disease.
A reliable technique for rapid & smooth extubation with stable hemodynamics is still not fully evolved.
Aims: To compare the effect of intravenous magnesium sulphate and esmolol for attenuating hemodynamic
response to extubation after general anesthesia.
Setting and Design: Prospective, randomized, double blind study conducted at tertiary care hospital.
Methods: Sixty adult subjects undergoing major surgery were randomly divided into 2 groups. Group M
received magnesium sulphate 40 mg/kg & Group E received esmolol 0.6 mg/kg IV infusion over 5 minutes
before extubation. Heart rate, systolic & diastolic blood pressure, mean arterial pressure, rate pressure
product, pain score & sedation score were compared from extubation till 15 minutes after extubation.
Statistical Analysis: Students ‘t’ test used for continuous variables & Chi Square test for categorical data.
Results: 21.82% fall in heart rate was observed in group M with a plateau at 10 -15 minutes compared
to 37.07% in group E with a peak at 15 minutes (p=0.0150). Fall in Systolic blood pressure was 18.86%
in group M & 21.15% in group E (p=0.4298). Rate pressure product was significantly lower in group E
(50.40%) than group M (36.66%). Postoperative pain score was significantly less in group M compared to
group E (p
Conclusion: Magnesium sulphate provides better hemodynamic stability with postoperative analgesia
compared to esmolol when used for attenuating hemodynamic response to extubation.
Keyword :
Magnesium sulphate, Esmolol, Hemodynamic response, Extubation response, Postoperative analgesia.