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Abstract

 
Abstract
Objective: This study aimed to compare the efficacy of esmolol and fentanyl in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation.
Methodology: A randomized controlled trial was conducted at CPEIC Multan, involving 194 patients undergoing elective surgery under general anesthesia. Patients were divided into two groups: Group A received 0.5 mg/kg of intravenous esmolol, and Group B received 1 mcg/kg of intravenous fentanyl, administered three minutes before intubation. Hemodynamic parameters, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were recorded at baseline and five minutes post-intubation.
Results: Both groups had comparable demographic and baseline hemodynamic characteristics. Post-intubation, Group A exhibited significantly lower HR (84.18±6.33 bpm) than Group B (96.72±5.39 bpm, p<0.001). Although SBP and DBP differences between the groups were not statistically significant (p=0.112 and p=0.229, respectively), MAP was significantly lower in Group B (92.48±8.44 mmHg) compared to Group A (96.14±6.89 mmHg, p=0.001).
Conclusion: Esmolol was more effective in attenuating the tachycardic response to laryngoscopy and intubation, whereas fentanyl showed a greater effect on MAP reduction. These findings suggest esmolol may be preferable for controlling heart rate, while fentanyl may better manage blood pressure surges. Tailored dosing or adjunct therapies might be necessary for comprehensive hemodynamic control.