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Abstract This double blind randomized placebo controlled study was designed to assess the effect of Esmolol versus lidocaine in blunting of the haemodynamic response and increased IOP during extubation in geriatric patients submitted for catarct extraction and IOL operation. 30 patients, aged > 65 years of ASA I or II were included in this study. Anaesthesia was induced by propfol mg/kg, succynilcholine (1mg/kg) and maintained by N2O : O2 (2 : 1), halothane and atracurium. The patients were randomized into three groups (10 patients each). In the first group (control), patients received 5ml saline, in lidocaine group, 1mg/kg lidocaine was given as a bolus dose and in Esmolol group, 1mg/kg Esmolol was given. All these drugs were given after reversal and before extubation. The recorded data included the haemodynamic parameters (HR, SBP, DBP, MBP) and IOP. They were recorded before induction (basal), 1.2min after intubation, after reversal (before drug administration) and lastly 1, 3, 5, 10min after extubation. The results of this study showed significant decrease in HR after extubation in Esmolol group as related to control and lidocaine groups. IOP decreased significantly after extubation in both lidocaine and Esmolol groups as compared with control one. However, in Esmolol group, this significance appeared early (1min) while in lidocaine one, it appeared later (3min) but continued up to 10 min post extubation. On the other hand, arterial blood pressure showed no significant differences between the 3 groups. From this study we can conclude that both Esmolol and lidocaine in the given dose can control IOP after extubation while Esmolol is superior to lidocaine in blunting of the tachycardia which accompany extubation. |