Effects of Esmolol on the Prevention of Haemodynamic Responses to Tracheal Extubation after Craniotomy Operations

Alkaya, Murat Alp; Saraçoğlu, Kemal Tolga; Pehlivan, Gokhan; Etı, Zeynep; Göğüş, F. Yılmaz

doi:10.5152/tjar.2013.57

Cited by 16 publications

(14 citation statements)

References 19 publications

(9 reference statements)

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“…In Alkaya et al . 's[ 9 ] study, no complications were noted even though esmolol was used at 2 mg/kg, probably because infusion was started 5 min before extubation as compared to 2–5 min before extubation in Dyson et al . 's[ 8 ] study.…”

Section: Discussionmentioning

confidence: 99%

Attenuation of hemodynamic response to tracheal extubation: A comparative study between esmolol and labetalol

Patel¹,

Mishra²,

Shivaramu³

2018

Anesth Essays Res

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Background and Aims:Cardiovascular stress response to extubation can result in elevated heart rate (HR) and mean arterial blood pressures which can be detrimental in high-risk patients.Settings and Design:The objective of this study is to compare the esmolol and labetalol efficacy in attenuating hemodynamic response to tracheal extubation.Materials and Methods:Sixty patients scheduled for elective surgical procedures were selected randomly and divided into two groups of thirty each. Group I - esmolol 1.5 mg/kg and Group II - labetalol 0.25 mg/kg were administered 2 min before extubation after following a standard perioperative anesthetic management. Hemodynamic parameters recorded include HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) at baseline, reversal, study drug, 1 min after study drug, extubation, and at 1, 2, 3, 4, 5, and 15 min postextubation.Statistical Analysis:Student's t-test and analysis of variance have been used to find the significance of study parameters between groups of patients. P <0.05 was considered statistically significant.Results:Both esmolol and labetalol obtunded extubation response throughout the extubation and postextubation period. At extubation and immediately postextubation at 1st and 2nd min, there was statistical significance (P < 0.05) in SBP, DBP, and MAP which showed esmolol was better than labetalol. Whereas labetalol was more efficient in controlling HR at 5th and 15th min postextubation having statistical significance.Conclusions:Both esmolol and labetalol attenuated hemodynamic response. Esmolol was more efficient than labetalol at extubation and immediately postextubation. If patient has tachycardia at extubation, labetalol is preferred. If patient has raised blood pressure, then esmolol is a good option in blunting the response.

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Section: Discussionmentioning

confidence: 99%

Attenuation of hemodynamic response to tracheal extubation: A comparative study between esmolol and labetalol

Patel¹,

Mishra²,

Shivaramu³

2018

Anesth Essays Res

View full text Add to dashboard Cite

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“…During extubation increased heart rate and blood pressure may result in complications such as cardiac failure, pulmonary edema and cerebral vascular haemerage. 10 Proposed mechanism behind these haemodynamic changes is increased sympathetic activity and release of catecholamines. Dexmedetomidine, active D isomer of medetomidine (4-{1-(2,3-dimethylphenyl) -ethyl}-1H-imidazole) is a highly specific and selective 2 adrenoceptor agonist.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of intravenous dexmedetomidine on haemodynamic responses during tracheal extubation in patients undergoing craniotomies

Goyal

Bandil²,

Bansal

2017

Int J Res Med Sci

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Background: Dexmedetomidine an α2 agonist reduces heart rate and blood pressure due to sympatholytic activity. The aim of this study was to evaluate the effect of dexmedetomidine on haemodynamic response during endotracheal extubation in patients undergoing craniotomies for intracranial space occupying lesion (ICSOL).Methods: Sixty patients of ASA grade I and II, age 18-50 years scheduled for craniotomy for nonvascular ICSOL were selected after randomization into 2 groups with 30 patients in each group. Group D and C received an IV infusion of dexmedetomidine 0.5 mg/kg and normal saline 100 ml respectively over 10 min at the time of skin closure in a double-blind manner. Heart rate, systolic and diastolic blood pressure were recorded just before drug administration, 3 and 5 minutes after drug administration, during extubation and at 3, 5, 10 and 15 minutes after extubation. Respiratory rate and oxygen saturation were analyzed at 3, 5, 10 and15 minutes after extubation. Any laryngospasm, bronchospasm, desaturation, respiratory depression, vomiting, hypotension and bradycardia was noted.Results: Heart rate, systolic and diastolic blood pressure increased during emergence time in both groups (p<0.05) but this increase was more significant in control group than group D. SBP and heart rate were significantly lower in group D from 3 minutes after drug administration to 15 minutes after extubation. DBP was lower in group D during extubation till 15 minutes after extubation (p<0.01). No significant differences were observed in the respect of adverse events between the groups.Conclusions: Intravenous dexmedetomidine 0.5 mg/kg before extubation is attenuates haemodynamic response during endotracheal extubation in craniotomies.

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“…10,[16][17][18][19] Like in the present study, esmolol prevented increases in blood pressure and heart rate during the phase of tracheal extubation. [20][21][22] Esmolol also assured a more stable haemodynamics during the non-cardiac [23][24][25] and cardiac surgery. 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.…”

Section: Discussionmentioning

confidence: 99%

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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Effects of Esmolol on the Prevention of Haemodynamic Responses to Tracheal Extubation after Craniotomy Operations

Abstract: We concluded that 2 mg kg(-1) esmolol infusion before extubation can prevent hypertension and tachycardia caused by extubation in patients undergoing elective craniotomy.

Cited by 16 publications

References 19 publications

Attenuation of hemodynamic response to tracheal extubation: A comparative study between esmolol and labetalol

Attenuation of hemodynamic response to tracheal extubation: A comparative study between esmolol and labetalol

The effectiveness of intravenous dexmedetomidine on haemodynamic responses during tracheal extubation in patients undergoing craniotomies

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

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