Comparison of two bolus doses of esmolol for attenuation of haemodynamic response to tracheal intubation.

372 arterial hypertension, aneurysmal vascular disease and decreased intracranial compliance2 is well known. The circulatory disturbances consist of elevation in heart . rate and systemic3·4 and pulmonary artery pressures5, which occasionally lead to myocardial ischaemia6, heart failure and cardiovascular catastrophies like myocardial infarct, cerebrovascular accident? These changes arise c from reflex sympathetic discharge resulting from epipharyngeal and laryngopharyngeal stimulation8, associated with increased plasma norepinephrine concentrations9,IO and are marked by increased blood pressure and heart rate. The search for effective