The haemodynamic responses during extubation can cause complications afteropen-heart surgery. In this study, we aimed to examine the effect of esmololand magnesium before extubation on these haemodynamic responses.

Following the approval of local Ethics Committee, 120 patients havingcoronary artery bypass grafting with extubation in the intensive care unitwere included in the study. Patients were allocated to receive esmolol 1 mgkg−1 (group I, n = 40), magnesium 30 mg kg−1 (Group II,n = 40) or normal saline (Group III,n = 40). Study medication wasadministered as a 20-min infusion in a volume of 20 mL. Patients wereextubated just after termination of the infusion. Heart rate, blood pressureand central venous pressure were recorded prior to drug administration,before extubation, during extubation and 1 min after extubation.

Heart rate was lower in Group I than in Groups II (P < 0.05) and III (P < 0.001) and lower inGroup II than in Group III (P < 0.05) during extubation. It wasalso lower in Group I than in Group III (P < 0.05) afterextubation. Systolic blood pressure was lower in Group I than in Groups IIand III (P < 0.001) during extubation. Diastolic blood pressurewas higher in Group III than in Groups I and II during extubation (P< 0.001) and after extubation (P < 0.05). Meanarterial pressure was lower in Group I than in Groups II and III (P< 0.001) during extubation, lower in Group II than in Group III(P < 0.05) during extubation and lower in Group I than in GroupIII (P < 0.05) after extubation.

We found that using esmolol before extubation following coronary arterybypass graft surgery prevents undesirable haemodynamic responses whilemagnesium reduces undesirable haemodynamic responses but does not preventthem.