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Background: Tracheal extubation is associated with a 10–30% increase in arterial pressure and heart ratethat could be detrimental in patients with hypertension, ischemic heart disease, and cerebrovascular disease.A reliable technique for rapid & smooth extubation with stable hemodynamics is still not fully evolved.Aims: To compare the effect of intravenous magnesium sulphate and esmolol for attenuating hemodynamicresponse to extubation after general anesthesia.Setting and Design: Prospective, randomized, double blind study conducted at tertiary care hospital.Methods: Sixty adult subjects undergoing major surgery were randomly divided into 2 groups. Group Mreceived magnesium sulphate 40 mg/kg & Group E received esmolol 0.6 mg/kg IV infusion over 5 minutesbefore extubation. Heart rate, systolic & diastolic blood pressure, mean arterial pressure, rate pressureproduct, pain score & sedation score were compared from extubation till 15 minutes after extubation.Statistical Analysis: Students ‘t’ test used for continuous variables & Chi Square test for categorical data.Results: 21.82% fall in heart rate was observed in group M with a plateau at 10 -15 minutes comparedto 37.07% in group E with a peak at 15 minutes (p=0.0150). Fall in Systolic blood pressure was 18.86%in group M & 21.15% in group E (p=0.4298). Rate pressure product was significantly lower in group E(50.40%) than group M (36.66%). Postoperative pain score was significantly less in group M compared togroup E (pConclusion: Magnesium sulphate provides better hemodynamic stability with postoperative analgesiacompared to esmolol when used for attenuating hemodynamic response to extubation.Keywords: Magnesium sulphate, Esmolol, Hemodynamic response, Extubation response, Postoperative analgesia.

Comparison of IV magnesium sulphate and IV esmolol in attenuating hemodynamic extubation response after general anesthesia