Journal of Advances in Medical and Biomedical Research

en Infusion Versus Bolus Esmolol on Hemodynamic Responses to Intubation in Patients Undergoing Coronary Artery Bypasses Grafting: a Randomized Clinical Trial Clinical Medicine Clinical Medicine کارآزمایی بالینی Clinical Trials Background and Objective: Perioperative myocardial ischemia remains one of the most serious complications of cardiac surgery. This study aimed to evaluate the effect of bolus esmolol versus its infusion on hemodynamic responses after laryngoscopy and intubation in patients undergoing coronary artery bypass grafting (CABG). Materials and Methods: This double-blind randomized clinical trial was conducted on 75 patients that were allocated into three groups. In the infusion group, 10 minutes prior to laryngoscopy 0.5 mg/kg esmolol was injected, and then, 200 µg/kg/minute esmolol was infused. In the bolus group, 2 minutes prior to the laryngoscopy 1.5 mg/kg bolus dose of esmolol was injected intravenously. In the control group, a bolus dose of normal saline was administered. Heart rate (HR), Systolic (SBP) and diastolic (DBP) blood pressures and mean arterial pressure (MAP), were recorded every one minute from 10 minutes prior to laryngoscopy to 10 minutes after intubation. Repeated measure ANOVA was applied as statistical analysis. Results: SBP was at the lowest rate since laryngoscopy was started until 10 minutes after intubation in the esmolol infusion group (P= 0.029). From the initiation of laryngoscopy to 6 minutes after the intubation, DBP was at the lowest rate in the infusion group. There was a significant difference between the groups regarding DBP changes during the measurement. ANOVA model showed that interaction between time and groups on SBP, MAP, and HR (P< 0.05). Conclusion: According to our results, the exact doses of esmolol infusion significantly reduced the level of SBP during intubation, compared with bolus esmolol. Esmolol, Laryngoscopy, Tracheal Intubation, Hemodynamic, CABG 101 108 http://journal.zums.ac.ir/browse.php?a_code=A-10-5680-1&slc_lang=en&sid=1 Mohammadreza Tashakkor mohamadrezatashakor86@gmail.com 5200319475328460073377 5200319475328460073377 No Dept. of Anesthesiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran Hossein Akbari akbari1350_h@yahoo.com 5200319475328460073378 5200319475328460073378 Yes Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran Mehrdad Mahdian mmahdian78@gmail.com 5200319475328460073379 5200319475328460073379 No Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran Mohammad Tobeiha mtobeiha.md@yahoo.com 5200319475328460073380 5200319475328460073380 No Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran