A Comparative Study Between Intravenous Esmolol and Intravenous Labetalol for Attenuation of Haemodynamic Response During Laryngoscopy and Tracheal Intubation

Abstract

Background: “ Laryngoscopy and tracheal intubation trigger sympathetic responses, causing transient elevations in heart rate and blood pressure, which may be hazardous in patients with cardiovascular risk. Beta-blockers such as esmolol and labetalol are commonly used to attenuate these hemodynamic responses. Aim: To compare the efficacy of intravenous esmolol and labetalol in blunting the hemodynamic response during laryngoscopy and tracheal intubation in adult patients undergoing elective surgery. Methodology: A prospective, hospital-based, comparative observational study was conducted on 90 ASA I–II adult patients, randomized to receive esmolol (0.5 mg/kg, n=45) or labetalol (0.25 mg/kg, n=45) before intubation. Hemodynamic parameters—heart rate, diastolic blood pressure, and rate pressure product—were recorded at baseline, post-induction, intubation, and at 1, 3-, 5-, 10-, and 15-minutes post-intubation. Results: Baseline parameters were comparable between groups. Labetalol produced significantly lower heart rates, diastolic pressures, and rate pressure product than esmolol at most time points, indicating superior attenuation of cardiovascular stress. A transient 3–5-minute window showed comparable efficacy. Conclusion: Intravenous labetalol (0.25 mg/kg) provides more sustained hemodynamic stability than esmolol (0.5 mg/kg) during laryngoscopy and intubation, making it the preferred agent for peri-intubation cardiovascular protection