2. INTRODUCTION
Endotracheal intubation has become an
integral part of anesthetic management and
critical care since it was first described by
Rowbotham and Magill in 1921
Direct laryngoscopy and endotracheal
intubation is invariably associated with
hemodynamic changes due to reflex
sympathetic discharge which can lead to
hypertension, tachycardia and arrhythmias.
The hypertension though transient may cause
pulmonary edema, myocardial
insufficiency, intracranial hemorrhage and rise
in intracranial pressure
Hence it is important to attenuate these
hemodynamic responses to laryngoscopy and
