Efeito de diferentes doses de esmolol sobre a resposta hemodinâmica, BIS e resposta de movimento durante a intubação orotraqueal: estudo prospectivo, randômico e duplo‐cego

Çakırgöz, Mensure Yılmaz; Taşdöğen, Aydın; Olguner, Çimen; Korkmaz, Hülya; Öğün, Ertuğrul; Küçükebe, Burak; Duran, Esra

doi:10.1016/j.bjan.2013.09.008

Cited by 7 publications

(4 citation statements)

References 41 publications

(30 reference statements)

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“…Furthermore, another study has shown that a bolus injection of esmolol 1 mg/kg prior to intubation and continuous infusion at 150 μg/kg/min also resulted in blunted hemodynamic changes. [ 21 ] Overall, multiple studies with various designs have been performed thus far.…”

Section: Discussionmentioning

confidence: 99%

Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

et al. 2020

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Background: Lightwand is a convenient tool that can be used instead of a laryngoscope for intubation. Tracheal intubation causes direct stimulation of the larynx, drastically increasing hemodynamic values including blood pressure and heart rate. This study aims to identify the effect of different doses of esmolol on hemodynamic changes during lightwand intubation.Methods: The study subjects included 140 patients who underwent general anesthesia for elective surgery. The patients were randomly divided into four groups (35 patients in each group). The ‘C’ group only received 20 ml of normal saline, while the ‘E0.5’, ‘E1’, and ‘E2’ groups received 20 ml of normal saline containing esmolol—0.5 mg/kg, 1 mg/kg, and 2 mg/kg, respectively, injected 2 min prior to intubation. The patients’ blood pressure, heart rate, and rate-pressure product were measured six times, before and after the intubation.Results: The degree of heart rate elevation was suppressed in the E1 and E2 groups compared to the C group, and RPP after intubation significantly decreased in the E2 group compared to the C group.Conclusions: 1–2 mg/kg of a single esmolol injection prior to lightwand intubation effectively blunts heart rate elevation, and 2 mg/kg of esmolol injection blunts rate-pressure product elevation.

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Section: Discussionmentioning

confidence: 99%

Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

et al. 2020

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“…Desta maneira, a estreita relação entre taquicardia e isquemia do miocárdio sugeriu o uso de bloqueadores dos receptores β-adrenérgicos para a supressão da resposta hemodinâmica à intubação traqueal, como por exemplo o esmolol que é um antagonista cardiosseletivo do receptor ß1 de ação ultracurta 3 . É eficaz no embotamento das respostas aos estímulos adrenérgicos perioperatórios, incluindo intubação traqueal, eventos intraoperatórios causados pela diminuição da profundidade anestésica e extubação traqueal 4 .…”

Section: Introductionunclassified

“…No entanto, estudos revelam que o esmolol pode potenciar a redução das necessidades de anestésicos durante a anestesia com propofol ou inalatória. Além disso, sugeriu-se que a infusão de esmolol reduziu o uso intraoperatório de fentanil, diminuindo as respostas hemodinâmicas e reduziu o consumo de morfina no período pós-operatório 3 .…”

Section: Introductionunclassified

Uso De Esmolol No Intraoperatório E No Pós-Operatório De Cirurgias Não Cardíacas: Uma Revisão Integrativa

Lima¹,

Pacífico²,

Filho³

2021

RECIMA21

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O esmolol é um antagonista cardiosseletivo do receptor ß1 de ação ultracurta. É eficaz no embotamento das respostas aos estímulos adrenérgicos perioperatórios, incluindo intubação traqueal, eventos intraoperatórios causados pela diminuição da profundidade anestésica e extubação traqueal. Desta maneira, foi objetivo deste estudo analisar na literatura nacional e internacional os efeitos do esmolol no período periopertaório e pós-operatório de cirurgias não cardíacas. Trata-se de uma revisão integrativa de literatura realizada na Biblioteca Virtual da Saúde, sendo selecionados os artigos da base de dados da literatura científica e técnica da América Latina e Caribe (LILACS) e do Medical Literature Analysis and Retrieval System Online (MEDLINE). Os resultados revelaram que administração de esmolol trouxe benefícios, não sendo mencionado nenhum maléficio com uso, onde em infusão essa medicação é mais eficaz que em bolus para controlar da pressão arterial sistólica durante a intubação endotraqueal e esternotomia, reduzindo significativamente a necessidade de anestésico-analgésico, dor e incidência de NVP. As pesquisas também meniconaram que o esmolol teve um efeito poupador de opióides no período intraoperatório e pós-operatório imediato em pacientes hipertensos submetidos à laparoscopia. Esmolol em infusão intravenosa reduziu o consumo de analgésicos tanto no intraoperatório quanto no pós-operatório, reduziu os escores da escala analógica visual no pós-operatório imediato e prolongou o tempo para a primeira analgesia. Portanto, foi possível constatar que o esmolol é uma medicação segura, com muitas vantagens e com poucos efeitos adversos.

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“…Laryngoscopy and tracheal intubation (TI) during anesthesia induction boost catecholamine release by sympathetic stimulation, which may lead to increased blood pressure (BP), heart rate (HR), and arrhythmia, and cause myocardial ischemia and infarction in patients with risk factors, such as high BP and ischemic heart disease. 1 2 Local anesthetics, beta receptor blockers, and opiates are thus used to prevent cardiovascular changes during intubation1 and some studies have shown that fentanyl, sufentanil, alfentanil, and other opioids prevent the changes induced by interventions with anesthesia. 3 4 5 6 …”

Section: Introductionmentioning

confidence: 99%

Efficacy of dexmedetomidine versus remifentanil to blunt the hemodynamic response to laryngoscopy and orotracheal intubation: a randomized clinical trial

et al. 2018

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The study aims to compare the efficacy of dexmedetomidine (DEX) vs. remifentanil (REM) to blunt the hemodynamic response to laryngoscopy and orotracheal intubation. Enrolled in a double-blind clinical trial, 124 patients undergoing elective surgery under general anesthesia at Amirkabir Hospital (Arak, Iran), were assigned into four groups equally (31 patients in each group), DEX, REM, DEX-REM, and normal saline (NS), who received intravenous DEX (1 µg/kg), REM (1 µg/kg), their equal mixture (each 0.5 µg/kg, 1 minute before tracheal intubation), and NS, respectively. Then, blood pressure (BP), heart rate (HR), and arterial oxygen saturation (SaO2) were measured on arrival to the operating room, 1 minute before laryngoscopy and tracheal intubation, immediately after intubation, and afterwards every 5 to 15 minutes, and finally the data were analyzed using SPSS 18.0. The groups were same regarding to age, sex and baseline hemodynamic variables including mean of BP (P = 0.157), HR (P = 0.105) and SaO2 (P = 0.366). Tukey post-hoc test showed that there DEX, REM, and a DEX + REM groups was same regarding to MBP and HR, but these hemodynamic responses were higher in NS group than other groups at all time after laryngoscopy and intubation (P < 0.05). Moreover, repeated measure test showed a decreasing trend in MBP and HR in three intervention groups at all time after intubation (P > 0.05). A DEX/REM mixture had the lowest BP and three intervention groups had lower HR than the NS group. A mixture of the drugs used seems to lead to not only a prevented increase in HR and BP during laryngoscopy but also a decreased BP and HR. This study was registered in Iranian Registry Clinical Center with the registration No. IRCT2016092722254N1.

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Efeito de diferentes doses de esmolol sobre a resposta hemodinâmica, BIS e resposta de movimento durante a intubação orotraqueal: estudo prospectivo, randômico e duplo‐cego

Abstract: In clinical practise we believe that after 1mgkg(-1) loading dose, 150μgkg(-1)min(-1) iv esmolol dose is sufficient to suppress responses to tracheal intubation without increasing side effects.

Cited by 7 publications

References 41 publications

Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

Uso De Esmolol No Intraoperatório E No Pós-Operatório De Cirurgias Não Cardíacas: Uma Revisão Integrativa

Efficacy of dexmedetomidine versus remifentanil to blunt the hemodynamic response to laryngoscopy and orotracheal intubation: a randomized clinical trial

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