Rehman Azhar and Afshan Gauhar
Background: Sympathetic response associated with tracheal extubation is recognized as a potential cause for a number of complications in surgical patients during the perioperative period. Various methods are used in normotensive patients to attenuate tracheal extubation response and all these methods are associated with adverse effects like hypotension and bradycardia. The aim of the study was to examine the effect of metoprolol in comparison with verapamil to attenuate the hemodynamic response at tracheal tube extubation.
Methods: A total number of 90 hypertensive patients with systolic blood pressure below 150 mm Hg and diastolic blood pressure below 90 mm Hg were randomly divided into three groups named as placebo (A), verapamil (B) and metoprolol (C). Heart rate and blood pressure trends were monitored at different time intervals.
Results: Hemodynamic responses at the time of extubation including heart rate, systolic blood pressure and diastolic blood pressure were well controlled in the metoprolol group as compared to placebo and verapamil groups. Adverse effects such as bradycardia and hypotension were not observed in metoprolol group.
Conclusion: Metoprolol is more effective as compared to placebo and verapamil in attenuating the hemodynamic response to tracheal extubation in hypertensive patients.