Analysis of the effects of esmolol in preventing cardiovascular reaction caused by endotracheal intubation and extubation in general anesthesia patients

ObjectiveTo investigate the effects of esmolol on cardiovascular reaction caused by endotracheal intubation and extubation in general anesthesia patients.

MethodsSixty-one patients scheduled by operation with endotracheal intubation were divided into the control group(31 cases) and observation group(30 cases) according to simple random number method.The control group was treated with routine general anesthesia, and the observation group was slowly injected with l mg/kg of esmolol before and after conventional anesthesia.The systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) before anesthesia(T₀), before endotracheal intubation(T₁), immediately after endotracheal intubation(T₂), after endotracheal intubation(T₃), before extubation(T₃), immediately after extubation(T₅) and after 3 min of extubation(T₆) were analyzed in two groups.The serum levels of epinephrine(Ad) and norepinephrine(NA) at T₀, T₃ and T₆, and occurrence of perioperative adverse reactions were detected in two groups.

ResultsThe results of repeated measurement ANOVA showed that the differences of the interaction of SBP, DBP and HR at time factor, and time factor and grouping were statistically significant(P < 0.01).The results of multiple post-mortem comparisons showed that the levels of SBP, DBP and HR in two groups at T₁ were lower than those at T₀(P < 0.05), the levels of SBP, DBP and HR in two groups at T₂ and T₃ were higher than those at T₁(P < 0.05), the levels of SBP, DBP and HR in control group at T₅ and T₆ were higher than those at T₄(P < 0.05), and the level of HR in observation group at T₅ was higher than that at T₄(P < 0.05).The results of comparison among groups showed that the levels of SBP, DBP and HR in observation group at T₂ and T₃ were lower than those in control group(P < 0.05), the level of HR in observation group at T₄ were lower than that in control group(P < 0.05), and the levels of DBP and HR in observation group at T₅ and T₆ were lower than those in control group(P < 0.05).The results of repeated measure ANOVA showed that the differences of the interaction of Ad and NA at time factor, and time factor and grouping were statistically significant(P < 0.05 to P < 0.01).The results of multiple post-mortem comparisons showed that the levels of Ad and NA in observation group at T₃ and T₆ were lower than those in control group(P < 0.05), the levels of Ad and NA in control group at T₃ and T₆ were significantly higher than those at T₀(P < 0.05), and differences of the levels of Ad and NA in observation group among T₀, T₃ and T₆ were not statistically significant(P>0.05).The incidence rate of cough during extubation in control group(77.42%) was significantly higher than that in observation group(43.33%)(P < 0.01).

ConclusionsEsmolol can effectively relieve the cardiovascular response caused by tracheal intubation and extubation under general anesthesia, has good safety, and is worthy of clinical popularization.