A prospective randomized double-blind controlled trial on evaluating the Efficacy of Inj.Metoprolol 50µgm/Kg. I.V., in attenuating the hemodynamic response to laryngoscopy, intubation and carbon diox

Introduction: We evaluated the efficacy of inj.Metoprolol 50 µgms/kg. i.v. given 5 minutes before induction of anesthesia in attenuating the hemodynamic response to intubation and CO2 pneumoperitoneum. Materials and Method: We conducted a randomized double-blind controlled study on 60 patients. Five minutes before induction of anesthesia, either inj. Metoprolol 50µgm/kg diluted to 10 ml or 10ml normal saline given intravenously. Heart Rate(HR) and MAP recorded at basal, one, five minutes after Intubation, 15 minutes after establishing pneumoperitoneum, before and after extubation were analyzed with Descriptive statistics. Results: In Both the groups no significant increase was observed in HR at 1 minute and 5 minutes after intubation compared to the basal HR. But the MAP at 1 and 5 minutes after intubation increased significantly in control group, whereas no significant increase occurred in Metoprolol group. HR and MAP recorded at 15 minutes after pneumoperitoneum showed significant increase from both basal and pre pneumoperitoneum values in control group but no significant increase was observed in Metoprolol group. During Extubation also no significant increase in HR and MAP observed in Metoprolol group compared to pre extubation values whereas Control group showed significant increase in HR and MAP after extubation compared to pre extubation values. Conclusion: Intravenous Metoprolol 50 µgms/kg. i.v. given 5 minutes before induction of anesthesia reduces adverse hemodynamic changes during intubation and pneumoperitoneum during laparoscopic surgeries. There are no significant adverse effects during surgery or 8 hours post operatively.