Comparison of Magnesium Sulphate and Esmolol In Attenuating the Cardiovascular Responses to Tracheal Extubation –A Prospective, Randomized, Comparative Indian Study

ABSTRACT

Tracheal extubation is known to cause a rise in systolic, diastolic and arterial blood pressure. Present study was conducted to compare MgSO4 and Esmolol with regards to their effects on haemodynamic extubation stress response in patients after general anaesthesia. Study population comprised of 60 patients aged between 20 and 50 years, with ASA grade I and II scheduled for elective surgery under general anesthesia with intubation. Group M received IV magnesium sulphate-40mg/kg and Group E received IV esmolol-0.6 mg/kg, both diluted in 100 ml NS started 5 minutes before extubation. Intergroup comparison of heart rate, mean arterial pressure, systolic and diastolic blood pressure was done before extubation, at time of extubation, 3mins, 5mins and 10mins after extubation. Quality of extubation was evaluated and compared between groups with extubation quality score and modified Ramsay sedation score. Demographic details were statistically comparable between study groups in terms of age, weight, sex, ASA grade. Mean HR after extubation was significantly lower in group E (p<0.05). MAP, SBP and DBP after extubation were significantly lower in esmolol group (p<0.05). Mean EQS was significantly higher in group E (p<0.05) after extubation. Mean MRS was higher in group M after extubation (p<0.05).Mean extubation time in group E was lower than group M (p<0.05) Haemodynamic parameters were well controlled with both esmolol and MgSo4 and the readings were in clinically normal range for both groups. However quality of extubation and sedation was superior with MgSo4.

Keywords: BP, HR, MAP, SBP, DBP, Esmolol, MgSO4, EQS, MRS