Comparison between the Hemodynamic Profile with Esmolol versus Morphine as an Adjuvant Agent during Induction of Anesthesia

Main Article Content

Usama Farooq
Rashid Ali
Tariq Mehmood
Neelofar Yousaf
Hafiz Ahmed Hassam Bhalli
Kenan Anwar Khan
Muhammad Farrukh Habib

Abstract

Background: The induction of general anesthesia is a critical phase in anesthetic practice, often associated with significant hemodynamic changes. These changes can lead to complications due to autonomic adrenergic responses. Esmolol, a beta-1 antagonist, is commonly used to blunt these responses, but its availability is limited in some settings. Morphine, a pure mu receptor antagonist, presents a potential alternative.


Objective: This study aimed to compare the efficacy of intravenous esmolol versus intravenous morphine in stabilizing the hemodynamic profile during the induction of general anesthesia.


Methods: This randomized controlled trial was conducted at the Department of Anesthesiology, Combined Military Hospital, from January to June 2023. After obtaining ethical approval and trial registration, 220 ASA-II patients aged 25-55 years scheduled for elective surgeries under general anesthesia were enrolled. Patients were randomized into two groups: Group E (n=110) received 1.5 mg/kg intravenous esmolol three minutes before laryngoscopy and intubation, and Group M (n=110) received 0.1 mg/kg intravenous morphine five minutes before laryngoscopy and intubation. Baseline heart rate, systolic and diastolic blood pressure, and oxygen saturation were recorded after pre-oxygenation with 100% oxygen for three minutes. Post-intubation, the same parameters were measured five minutes after intubation. Statistical analysis was performed using SPSS version 25.0, with independent samples T-tests used to compare means. A p-value of ≤0.05 was considered statistically significant.


Results: The mean age was 39.41 ± 5.13 years in Group E and 39.97 ± 5.08 years in Group M (p=0.414). Mean weight was 68.14 ± 3.88 kg in Group E and 68.08 ± 3.80 kg in Group M (p=0.916). Pre-induction mean heart rate was 71.75 ± 2.33 bpm in Group E and 71.58 ± 2.35 bpm in Group M (p=0.585). Five minutes post-intubation, mean heart rate was significantly lower in Group E (80.73 ± 2.54 bpm) compared to Group M (87.62 ± 2.83 bpm) (p<0.001). Mean systolic blood pressure post-intubation was 132.88 ± 4.65 mm Hg in Group E and 140.25 ± 2.39 mm Hg in Group M (p<0.001). Mean diastolic blood pressure post-intubation was 77.58 ± 2.35 mm Hg in Group E and 85.33 ± 3.71 mm Hg in Group M (p<0.001). Oxygen saturation remained stable in both groups.


Conclusion: Intravenous esmolol is superior to intravenous morphine in blunting the hemodynamic responses to laryngoscopy and intubation, providing a more stable hemodynamic profile during the induction of general anesthesia.

Article Details

How to Cite
Farooq, U., Ali, R., Mehmood, T., Yousaf, N., Bhalli, H. A. H., Khan, K. A., & Habib, M. F. (2024). Comparison between the Hemodynamic Profile with Esmolol versus Morphine as an Adjuvant Agent during Induction of Anesthesia. Journal of Health and Rehabilitation Research, 4(2), 619–623. https://doi.org/10.61919/jhrr.v4i2.348
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Articles
Author Biographies

Usama Farooq, Combined Military Hospital Rawalpindi Pakistan.

Graded Anesthetist, Combined Military Hospital Rawalpindi, Pakistan.

Rashid Ali, Combined Military Hospital Rawalpindi Pakistan.

Graded Anesthetist, Combined Military Hospital Rawalpindi, Pakistan.

Tariq Mehmood, Combined Military Hospital Rawalpindi Pakistan.

Anesthetist, Combined Military Hospital Rawalpindi Pakistan.

Neelofar Yousaf, Akhtar Saeed Medical and Dental College Lahore Pakistan.

Department of Pharmacology, Akhtar Saeed Medical and Dental College Lahore, Pakistan.

Hafiz Ahmed Hassam Bhalli, Combined Military Hospital Rawalpindi, Pakistan.

Graded Anesthetist, Combined Military Hospital Rawalpindi, Pakistan.

Kenan Anwar Khan, Combined Military Hospital Rawalpindi Pakistan.

Graded Anesthetist, Combined Military Hospital Rawalpindi, Pakistan.

Muhammad Farrukh Habib, Shifa Tameer E Millat University Islamabad Pakistan.

Department of Management Sciences, Shifa Tameer E Millat University Islamabad, Pakistan.

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