Abstract

GARCIA GARCIA, Edwin; GUIJARRO PONCIANO, Daniana; RODRIGUEZ CASAS, Ernesto  and  RAOLA SANCHEZ, María Esther. Esmolol versus nitroglycerin, control of the reflex response to laryngoscopy and tracheal intubation in hypertensive patients. Rev Cub Med Mil [online]. 2005, vol.34, n.2. ISSN 0138-6557.

Layngoscopy and endotracheal intubation are a stimulus causing a marked sympathetic response in hypertensive patients. In order to compare the effects of esmolol and nitroglycerin on this response, 30 patients treated with nifedipine were studied, and it was decided to perform surgery with general anesthesia at "Dr. Carlos J. Finlay" Military Central Hospital. A group of 15 patients received esmolol 200 mg/kg by endovenous route before undergoing laryngoscopy, whereas the other 15 patients were administered nitroglycerin as a bolus, 2 mg/kg. Systolic, diastolic and mean arterial pressure, and heart rhythm were registered. Arterial pressure decreased after the induction to attain the basal level following laryngoscopy, with higher figures in the group that received nitroglycerin. In the group that was administered esmolol, the heart rate was steady and the electrocardiographic modifications were minimum. A high incidence of sinus tachycardia and ventricular extrasystoles were reported in the group that was admnistered nitroglycerin. A better attenuation of the hemodynamic response was obtained by using esmolol.

Keywords : Endotracheal intubation; esmolol; nitroglycerin; hypertensive patients.