A Comparative Study of Attenuation of Hemodynamic Responses During Tracheal Extubation with Intravenous Magnesium Sulphate and Intravenous Esmolol in Surgeries Under General Anaesthesia

Abstract

Background: Tracheal extubation is frequently associated with undesirable hemodynamic responses such as tachycardia and hypertension due to sympathetic stimulation. These responses may be detrimental in patients with cardiovascular or cerebrovascular compromise. Various pharmacological agents have been evaluated to attenuate these responses, among which magnesium sulphate and esmolol have shown promising results.

Aim: To compare the efficacy of intravenous magnesium sulphate and intravenous esmolol in attenuating hemodynamic responses during tracheal extubation in patients undergoing surgeries under general anaesthesia.

Materials and Methods: This prospective, randomized comparative study was conducted on 85 patients aged 18–60 years, classified as ASA physical status I and II, undergoing elective surgeries under general anaesthesia. Patients were randomly allocated into two groups: Group M (magnesium sulphate) and Group E (esmolol). Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were recorded at baseline, at extubation, and at 1, 3, and 5 minutes after extubation. Data were analyzed using appropriate statistical tests.

Results: Both drugs attenuated the hemodynamic response during extubation; however, magnesium sulphate was significantly more effective than esmolol in controlling heart rate and blood pressure at extubation and in the immediate post-extubation period (p < 0.05).

Conclusion: Intravenous magnesium sulphate provides superior attenuation of hemodynamic responses during tracheal extubation compared to intravenous esmolol, with minimal adverse effects.