Özet:

Objective: It is well known that laryngoscopy and tracheal intubation induce hemodynamic changes by stimulating sympathoadrenergic responses. The aim of this study was to compare the effectiveness of dexmedetomidine, esmolol, fentanyl in preventing increases in heart rate and arterial blood pressure in response to laryngoscopy and tracheal intubation. Material and Methods: Sixty patiens, aged between 20-70 years were randomly allocated to 3 groups Exclusion criteria included unstable coronary artery disease, heart failure, atrial or ventricular tachyarrhythmias, 2° or 3° heart block, sinus node dysfunction and resting BP outside the range of 100/50-160/110 mmHg. All patients were transferred to the operating theatre and their blood pressures (NIBP), ECGs, peripheric O2 saturations were non-invasively monitorized. The esmolol group (Group E) received 500 μg kg-1 esmolol and the fentanyl group (Group F) received 1 μg kg-1 fentanyl 2 minutes before endotracheal intubation while the dexmedetomidine group (Group D) received 1 μg kg-1 dexmedetomidine 10 minutes before endotracheal intubation. Heart rates (HR), mean arterial pressures (MAP), systolic arterial pressures (SAP) and diastolic arterial pressures (DAB) were recorded before infusion (t1), 1 (t2) and 3 (t3) minutes before intubation and 1 (t4), 3 (t5), 5 (t6), 7 (t7) and 10 (t8) minutes after intubation. General anesthesia was induced with propofol (1.5 mg kg-1) and fentanyl. Rocuronium bromide (0.6 mg kg-1) was given to facilitate orotracheal intubation and general anaesthesia was maintained with 50 % nitrous oxide in oxygen and desflurane. Results: MAP, DAP and SAP values at all times were similar in all three groups (P>0.05). HR values were found significantly higher in group F than group D at 7. (t7) and 10. (t8) min. after intubation (p<0.05). Conclusion: We thought that esmolol and dexmedetomidine were more effective than fentanyl for attenuating hemodynamic response to laryngoscopy and intubation.

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