A comparative study of esmolol and dexmedetomidine on hemodynamic responses to carbon dioxide pneumoperitoneum during laparoscopic surgery

Bhattacharjee, Dhurjoti Prosad; Saha, Sauvik; Paul, Sanjib; Roychowdhary, Shibsankar; Mondal, Shirsendu; Paul, Suhrita

doi:10.4103/0259-1162.183564

Cited by 10 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, Zhang et al [27] found IO esmolol can effectively reduce the cardiovascular responses in operation, sustain hemodynamic stable, reduce myocardial oxygen consumption, and prevent perioperative adverse cardiovascular events during laparoscopic surgery for gastrointestinal cancer. Also, Verma et al [5] and Bhattacharjee et al [28] in placebo-controlled study, found both esmolol and diltiazem[5] and dexmedetomidine[28] infusions, provided stable IO hemodynamics and protected against stress response triggered by pneumoperitoneum during laparoscopic surgery, but esmolol significantly lowered HR and BP than in diltiazem at the creation of pneumoperitoneum. [29]…”

Section: Discussionmentioning

confidence: 99%

Esmolol infusion reduces blood loss and opiate consumption during fertility preserving myomectomy

Hamed

Ataalla

2019

Anesth Essays Res

View full text Add to dashboard Cite

Objectives:The objective of this study is to evaluate the effect of esmolol-induced hypotensive anesthesia (EIHA) on intra-operative (IO) bleeding during open myomectomy.Patients and Methods:Eighty-eight women were randomly divided into the study group received EIHA without uterine tourniquet and control group who received normotensive anesthesia with uterine tourniquet. EIHA was provided as priming dose of esmolol (0.5 mg.kg-1) before the induction of anesthesia and esmolol infusion (0.05-0.3 mg.kg-1.min-1) to maintain mean arterial pressure at 60–70 mmHg that was stopped on completion of myomectomy. Fentanyl was used as IO analgesia (loading dose: 1.0 μg.kg-1 then infusion of 0.2-0.4 μg.kg-1.h-1). All patients received 6% hydroxyethyl starch (HES; initially, 3 mL.kg-1 over 5-10 minutes and supplemental doses according to requirements) and Lactated Ringer's solution (LR; 5 mL.kg-1.h-1). Trigger for blood transfusion was hemoglobin concentration (HBC) <7 g.dL-1. Study outcomes included the extent of postoperative (PO) HBC deficit in relation to preoperative HBC, frequency of tourniquet application for the study patients, and total fentanyl consumption.Results:EIHA significantly reduced blood pressure measures since laryngoscopy and tracheal intubation till the end of surgery in the study group compared to control group. Eight study patients (18.9%) required tourniquet application for control of bleeding; however, amount of IO blood loss; total field visibility score and PO HBC deficit were non significantly lower in the study group. EIHA allowed significant reduction of the IO amount of LR and additional amounts of HES infusions. Study patients group consumed significantly lower IO fentanyl doses with significantly longer duration till the 1st PO request and the number of additional fentanyl, and lower numeric rating scale scores in study group compared to controls.Conclusion:Open myomectomy under EIHA is feasible and safe and allows fertility-sparing with minimal risk of blood transfusion. The applied procedure of EIHA allowed blunting of pressor reflexes secondary to LIT, surgical stresses and extubation, and allowed reduction of IO and PO opioid doses.

show abstract

Section: Discussionmentioning

confidence: 99%

Esmolol infusion reduces blood loss and opiate consumption during fertility preserving myomectomy

Hamed

Ataalla

2019

Anesth Essays Res

View full text Add to dashboard Cite

show abstract

“…In support of this finding, Sharma et al [36] , in placebo-controlled study, reported that both dexmedetomidine and esmolol suppressed hemodynamic responses to intubation when compared to placebo. Also, Verma et al [19] and Bhattacharjee et al [37] in placebo-controlled study, found both esmolol and diltiazem [19] or dexmedetomidine [37] infusions, provided stable IO hemodynamics and protected against stress response triggered by pneumoperitoneum during laparoscopic surgery, but esmolol induced significantly lower HR and blood pressures than in diltiazem at the creation of pneumoperitoneum [19] . In another comparative study, Prajwal Patel et al [38] found both esmolol and labetalol attenuated hemodynamic response, but if patient has raised blood pressure, esmolol is a good option in blunting the response.…”

Section: Resultsmentioning

confidence: 97%

Surgical Field Visibility during Functional Endoscopic Sinus Surgery: esmolol-induced hypotensive anesthesia versus hypotensive total intravenous anesthesia

Ahmed

Elsayed

Sarhan³

et al. 2019

International Journal of Medical Arts

View full text Add to dashboard Cite

Background: Functional endoscopic sinus surgery is widely practiced during daily otorhinolaryngology practice. It usually done under low blood pressure. However, the ideal hypotensive drug or technique is yet not well established. Aim of the work: To evaluate outcome of functional endoscopic sinus surgery under esmolol-induced hypotensive anesthesia [EHA] versus hypotensive total intravenous anesthesia [H-TIVA]. Patients & Methods: 72 patients were randomly divided into two groups; Group A: H-TIVA and Group B [EHA]. After induction of anesthesia, remifentanil/ propofol and esmolol infusions were adjusted to maintain mean arterial pressure at 60-70 mmHg. After completion of surgical procedure, esmolol infusion was stopped, while remifentanil/propofol infusions were adjusted to allow restoration of blood pressure. Operative field bleeding and visibility were graded using Fromme scale. Primary outcome is the efficacy of EHA to minimize intraoperative bleeding to an extent that allows satisfactory completion of surgery. Results: Esmolol bolus significantly attenuated pressor reflexes to induction and intubation than induction by remifentanil. Intraoperative [IO] heart rate and MAP measures were significantly lower with EHA. At 10-minures after infusion stoppage, patients of group B still had significantly lower HR and MAP, while at 10-min later, the difference was nonsignificant. HA minimized IO blood loss down to no to slight bleeding in 16.7% and 55.5% of studied patients and improved field visibility to satisfactory-to-good levels in 51.4% and 43.1% of surgeries, respectively. Moreover, EHA provided better field visibility, so allowed significant reduction of operative time than with TIVA. Conclusion: Hypotensive anesthesia is safe and appropriate modality for FESS and improves surgical and clinical outcome. Both esmolol and remifentanil provided satisfactory results. Esmolol is superior to remifentanil.

show abstract

“…With the development of aging society, the number of elderly patients with CRC have increased gradually (18). According to literature, carbon dioxide pneumoperitoneum may threaten the life of patients undergoing laparoscopic surgery (19,20). In particular, the postoperative recovery of elderly patients is often affected by anesthesia and other factors (21), and it can also directly affect the cost of treatment, length of stay, and morbidity (22).…”

Section: Discussionmentioning

confidence: 99%

Application of sevoflurane inhalation combined with epidural anesthesia in patients with colorectal cancer and its effect on postoperative perceptual function

Zhang¹,

Jiang

2019

Oncol Lett

View full text Add to dashboard Cite

Effect of sevoflurane inhalation combined with epidural anesthesia on postoperative perceptual function in patients with colorectal cancer (CRC) was investigated. The clinical data of 78 patients undergoing laparoscopic CRC radical surgery in The Second Cancer Hospital of Heilongjiang Province from June 2016 to June 2017 were retrospectively analyzed and divided into 2 groups: Sevoflurane inhalation combined with epidural anesthesia (observation group, n=40); propofol intravenous general anesthesia (control group, n=38). The mean arterial pressure and heart rate before anesthesia (T0), immediate intubation (T1), 30 min after surgery started (T2), end of surgery (T3), 10 min after extubation (T4) were compared between the two groups. The recovery conditions were also compared between the two groups. The cognitive functions were evaluated by mini-mental state scale (MMSE). The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group at T2, T3 and T4 (P<0.05). The recovery time, extubation time, anal exhaust time, eating time, urinary catheter removal time and hospital stay in the observation group were significantly lower than those in the control group (P<0.05). There was a significant difference in cognitive function between the two groups at different time points (P<0.001). Postoperative cognitive function showed a trend of decreasing first and then increasing; the scores of cognitive function in both groups 1 day after surgery were at trough level, and recovered gradually from 3 days after surgery. The mean arterial pressure and heart rate during the perioperative period are more stable in the elderly patients with sevoflurane inhalation combined with epidural anesthesia; the recovery time is shorter and more rapid, and the recovery time of postoperative cognitive function is also faster. Therefore, it provides a reference for patients undergoing CRC radical surgery to select high-quality and appropriate anesthetic protocols.

show abstract

A comparative study of esmolol and dexmedetomidine on hemodynamic responses to carbon dioxide pneumoperitoneum during laparoscopic surgery

Cited by 10 publications

References 21 publications

Esmolol infusion reduces blood loss and opiate consumption during fertility preserving myomectomy

Esmolol infusion reduces blood loss and opiate consumption during fertility preserving myomectomy

Surgical Field Visibility during Functional Endoscopic Sinus Surgery: esmolol-induced hypotensive anesthesia versus hypotensive total intravenous anesthesia

Application of sevoflurane inhalation combined with epidural anesthesia in patients with colorectal cancer and its effect on postoperative perceptual function

Contact Info

Product

Resources

About