Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Morais, Vinicius Barros Duarte de; Sakata, Rioko Kimiko; Huang, Ana Paula Santana; Ferraro, Leonardo Henrique da Cunha

doi:10.1590/s0102-865020200040000008

Cited by 7 publications

(5 citation statements)

References 25 publications

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“…26,27 Esmolol-induced continuous β-adrenergic receptor blockade leads to a more sparing use of opioid analgesics, which was demonstrated in the present study and other clinical trials alike. [28][29][30] In the current study, a very significant sparing of fentanyl and droperidol were registered.…”

Section: Discussionmentioning

confidence: 73%

Effects of the ultra-short-acting beta-blocker Esmolol infusion on cardiovascular parameters and quality of postoperative recovery in patients scheduled for elective plastic surgery

Lončar-Stojiljković¹

2021

Scripta Medica

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Background/Aim: Esmolol is an ultra-short-acting, easily titratable b-adrenergic receptor antagonist used for urgent treatment of hypertension and tachycardia in non-surgical and surgical settings. Aim of this clinical study was to investigate its cardiovascular effects and quality of the emergence from anaesthesia in patients scheduled for elective plastic surgery under general balanced anaesthesia. Methods: A total of 30 ASA I/II patients were randomised in two groups of similar demographic characteristics and baseline values of cardiovascular parameters. Esmolol group received esmolol dissolved in glucose 5 % as an intravenous infusion, 0.3 mg/kg/min during the first 5 min and at a rate of 0.1 mg/kg/ min thereafter. Control patients received the solvent only, at the same rate and volume. General balanced anaesthesia was induced with thiopentone sodium and fentanyl and maintained with nitrous oxide and oxygen. Neuromuscular relaxation was assured with pancuronium bromide and was antagonised at the end of operation with atropine and neostigmine. Systolic and diastolic blood pressure and heart rate were registered at all critical phases: (1) immediately prior to the induction (baseline value), (2) induction to anaesthesia, (3) tracheal intubation, (4) first skin incision, (5) surgical manipulation with organs, (6) suture of the surgical wound and (7) tracheal extubation. Drug consumption and quality of postoperative recovery were monitored. Results: In most of the critical phases of anaesthesia and operation, patients from the Esmolol group had significantly lower values of cardiovascular parameters than the patients from the Control group. Esmolol-treated patients needed less fentanyl, droperidol and pancuronium and had faster and smoother emergence from anaesthesia than the control patients. Conclusion: Esmolol improved haemodynamics and post-anaesthesia recovery in patients undergoing elective plastic surgery under general balanced anaesthesia.

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Section: Discussionmentioning

confidence: 73%

Effects of the ultra-short-acting beta-blocker Esmolol infusion on cardiovascular parameters and quality of postoperative recovery in patients scheduled for elective plastic surgery

Lončar-Stojiljković¹

2021

Scripta Medica

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“…The present study showed a significant opioid-sparing effect of esmolol and so did some other clinical trials. [21][22][23] Various publications even report on the decreased need for the administration of intravenous and inhalation anaesthetics as a result of esmolol iv bolus or infusion. 24,25 In the present study similar result was obtained, since there was a significantly lower need for isoflurane addition in the esmolol group, as compared to the control group of patients.…”

Section: Discussionmentioning

confidence: 99%

Esmolol as an adjunct to general balanced anaesthesia in neurosurgery

Lončar-Stojiljković¹,

Maksimović²,

Đurić³

2021

Scripta Medica

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Background/Aim: In surgery, and especially in the neurosurgical operations, maintenance of cardiovascular stability during and in the phase of the immediate postoperative recovery is of vital importance. The aim of this study was to investigate the effects of continuous esmolol infusion on the values of cardiovascular parameters and quality of the emergence from anaesthesia in neurosurgical patients. Methods: A total of 40 patients of both sexes scheduled for elective supratentorial surgery were randomly assigned to two groups. Esmolol group received intravenous (iv) infusion of esmolol dissolved in 5 % glucose solution (during the first 5 min at a rate of 0.3 mg/kg/min and thereafter at a rate of 0.1 mg/kg/min), while the ones from the control group received a 5 % glucose solution without esmolol at the same volume and rate. Cardiovascular parameters were registered at critical phases of anaesthesia and operation (induction, intubation, placement of Mayfield frame, craniotomy, skull closure, extubation). Recovery after anaesthesia was assessed based on times of eye opening on command, spontaneous eye opening and regaining of full orientation. Results: Values of systolic blood pressure and heart rate were significantly lower in the esmolol than in the control group of patients. Although the durations of anaesthesia did not differ, patients from the esmolol group required significantly less opioids and isoflurane and recovered after the anaesthesia significantly faster than the patients in the control group. Conclusion: Ultrashort-acting beta-adrenergic receptor antagonist esmolol, administered as a continuous iv infusion, assures better cardiovascular stability and smoother emergence from the balanced inhalation general anaesthesia than the control glucose infusion in elective neurosurgical patients.

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“…Studies have shown that esmolol, when used in continuous infusion, is effective in reducing undesirable hemodynamic effects such as hypertension and tachycardia during laryngoscopy maneuvers for orotacheal intubation [13][14][15]. Esmolol was also associated with lower intraoperative opioid consumption [16,17].…”

Section: Author Detailsmentioning

confidence: 99%

Introductory Chapter: Pharmacology of Airway Management in Emergency Medicine

Aslanidis,

Barros,

Darcy A. Bersot

2023

Airway Management in Emergency Medicine

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Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Cited by 7 publications

References 25 publications

Effects of the ultra-short-acting beta-blocker Esmolol infusion on cardiovascular parameters and quality of postoperative recovery in patients scheduled for elective plastic surgery

Effects of the ultra-short-acting beta-blocker Esmolol infusion on cardiovascular parameters and quality of postoperative recovery in patients scheduled for elective plastic surgery

Esmolol as an adjunct to general balanced anaesthesia in neurosurgery

Introductory Chapter: Pharmacology of Airway Management in Emergency Medicine

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