DOI: https://doi.org/10.36347/sjams.2026.v14i03.010

Pages: 371-379

Background: Laryngoscopy and endotracheal intubation provoke transient sympathetic stimulation leading to tachycardia and hypertension, which may be harmful even in normotensive patients with occult cardiovascular risk, particularly in resource limited tertiary settings. Various pharmacological strategies have been used to attenuate this response; however, the comparative efficacy of labetalol versus lignocaine in normotensive adults in Bangladeshi tertiary hospitals has not been well defined. Objective: To assess and compare the hemodynamic effects of intravenous labetalol versus lignocaine in attenuating the cardiovascular responses to laryngoscopy and endotracheal intubation among normotensive adult patients undergoing general anesthesia at a tertiary hospital in Barisal. Methods: This prospective, randomized, double blind clinical trial included 80 ASA I II normotensive adults (18 - 60 years) scheduled for elective non cardiac surgery under general anesthesia with orotracheal intubation, allocated to labetalol (LB, n=40) or lignocaine (LG, n=40). Patients in group LB received labetalol 0.25 mg/kg IV and those in group LG received lignocaine 1 mg/kg IV, each diluted to 10 ml and administered over 60 seconds, 5 minutes before laryngoscopy. Standardized anesthesia was used in both groups; heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline and at predefined time points, with primary analysis focused on MAP and HR at 1 minute after intubation. Data were analyzed using appropriate parametric and non parametric tests with p <0.05 considered statistically significant. Results: Demographic variables (age, sex, weight, ASA status) and baseline hemodynamic parameters were comparable between groups. At 1 minute after intubation, patients in the labetalol group exhibited significantly lower HR (88.9 ± 8.5 vs. 96.7 ± 9.4 beats/min), SBP (132.9 ± 11.2 vs. 144.8 ± 13.6 mmHg), DBP (83.1 ± 8.6