Effect of Intravenous Intraoperative Esmolol on Pain Management Following Lower Limb Orthopedic Surgery

Abstract

BackgroundLack of proper control of acute postoperative pain often leads to lingering or chronic pain. Several studies have emphasized the role of beta-blockers in reducing postoperative pain. Esmolol is a selective short-acting beta-blocker that produces few side effects. The purpose of this study was to examine the effect of intravenous intraoperative esmolol on postoperative pain reduction following orthopedic leg fracture surgery.MethodsIn a clinical trial, 82 patients between 20-65 years of age with tibia fractures and American Society of Anesthesiologists (ASA) physical status I & II who underwent surgery were divided into two groups. Group A received esmolol and group B received normal saline. Postoperative pain was measured at three time points: entering the recovery unit, and at 3 h and 6 h following surgery, using the Visual Analogue Scale (VAS). A P value of < 0.05 was considered significant.ResultsMean VAS scores at all three time points were significantly different between the two test groups (P = 0.02, P = 0.0001, and P = 0.0001, respectively). The consumption of pethidine was lower in group A than in group B (P = 0.004) and the duration of its effect was significantly longer in time (P = 0.026).ConclusionsIntravenous intraoperative esmolol is effective in the reduction of postoperative pain following leg fracture surgery. It reduced opioid consumption following surgery and delayed patient requests for analgesics.

Potentiation of Morphine-Induced Antinociception by Propranolol: The Involvement of Dopamine and GABA Systems

“…Propranolol alone ( Chen et al, 2012 ) or combined with lidocaine or dopamine ( Chen et al, 2015 ) intensified the analgesia against skin nociceptive stimuli in rats. Similar observations were reported for other β-adrenergic antagonists as atenolol ( Zaugg et al, 1999 ), labetalol ( Xiao et al, 2008 ), and esmolol ( Chia et al, 2004 ; Collard et al, 2007 ; Haghighi et al, 2015 ). In another study, β 2 -adrenergic receptors modulated both opioid tolerance and physical dependence.…”

“…For example, blockade of β-adrenoceptors in the joints connecting the jawbone to the skull induced antinociception in experimental animals ( Fávaro-Moreira et al, 2012 ). In clinical studies, esmolol ( Chia et al, 2004 ; Collard et al, 2007 ; Haghighi et al, 2015 ), atenolol ( Zaugg et al, 1999 ), and labetalol ( Xiao et al, 2008 ) demonstrated analgesic properties and reduced the recurrent postoperative pain. Coloma et al (2001) suggested that perioperative β-antagonist administration was an alternative to opioids to maintain postoperative analgesia.…”

Receipt of Pain Management Information Preoperatively Is Associated With Improved Functional Gain After Elective Total Joint Arthroplasty

“…Several studies have focused on TJR pain management during hospitalization [7][8][9][10][11][12] with less attention paid to addressing the management of pain after discharge. Currently, prescription pain medications such as opioids are the most common approach to managing pain postoperatively.…”

Effect of esmolol and lidocaine on agitation in awake phase of anesthesia among children

“…Esmolol is often used to maintain hemodynamic stability; it also relieves stress during surgery and lowers the requirement for narcotics postoperatively. [9,10] However, the use of esmolol to alleviate agitation in children has received little research attention. Many children become agitated after strabismus surgery because the eyes are covered postoperatively, although the exact reason remains unclear.…”