Efficacy and safety of intravenous esmolol for cardiac protection in non-cardiac surgery. A systematic review and meta-analysis

Ollila, Aino; Vikatmaa, Leena; Sund, Reijo; Pettilä, Ville

doi:10.1080/07853890.2018.1538565

Cited by 15 publications

(12 citation statements)

References 57 publications

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“…A meta-analysis showed that esmolol seems to be beneficial for the prevention of perioperative myocardial ischaemia. 17 Another study proved that esmolol 0.5 mg/kg combined with nicardipine 20 ug/kg during rapid-sequence induction can effectively reduce cardiovascular response. 18 Esmolol can also be used for controlled hypotension in various operations such as functional endoscopic sinus surgery (FESS), tympanoplasty and laparoscopic surgeries.…”

Section: Discussionmentioning

confidence: 98%

Effect of Different Concentrations of Esmolol on Perioperative Hemodynamics and Analgesia in Patients Undergoing Colectomy: A Prospective, Randomized Controlled Study

Song¹,

Yan-wu²,

Peng³

et al. 2021

DDDT

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Purpose The aim of this study was to investigate the efficacy of esmolol on intraoperative hemodynamic and perioperative analgesic management. Methods Totally, 125 patients undergoing colectomy were randomly divided into three groups. Group S (saline group) was administered 0.75 mL/kg/h of normal saline for 5 min before anesthesia induction and maintenance of 0.25 mL/kg/h; Group E 1 and Group E 2 were administered 0.5 mg/kg and 1.0 mg/kg esmolol for 5 min before anesthesia induction, and maintained of 0.5 mg/kg/h and 2.0 mg/kg/h, respectively. Several parameters including indexes of hemodynamics variation (primary outcome), intra- and postoperative analgesic usage, and pain score were measured. Results Group E 1 and Group E 2 had significantly lower intubation response than Group S (P = 0.007, P = 0.001), and extubation response of Group E 2 was significantly lower than Group S (P = 0.007). The opioid consumption in Group E 1 and Group E 2 was significantly lower than in Group S intraoperatively (P = 0.020 and 0.007). The incidence of postoperative adverse reactions among the three groups was not statistically significant (P = 0.368 and 0.772). Conclusion Esmolol 0.5 mg/kg and 1.0 mg/kg infusion before intubation both can effectively inhibit the intubation response, while only maintenance with 2.0 mg/kg/h of esmolol can reduce the incidence of extubation response. At the same time, esmolol can decrease intraoperative opioid requirement without increasing the risk of adverse reactions. Trial Registration ChiCTR1900024538 and the date of registration was July 15, 2019 at http://www.chictr.org.cn .

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Section: Discussionmentioning

confidence: 98%

Effect of Different Concentrations of Esmolol on Perioperative Hemodynamics and Analgesia in Patients Undergoing Colectomy: A Prospective, Randomized Controlled Study

Song¹,

Yan-wu²,

Peng³

et al. 2021

DDDT

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“…Hızlı başlangıç ve kısa etki süreli β-1 selektif ilaç olan esmolol, spesifik hemodinamik hedefe uygun ilaç titrasyonu ile ilaç dozunun bireyselleştirilmesine izin vermektedir. Böylece ilaca bağlı bradikardiyi ve hipotansiyonu en aza indirerek kardiyak koruma sağlayabilmektedir (18). Yaptığımız çalışmamızda hedef kalp atım hızına ulaşmak için intraoperatif dönemde ve postoperatif 48 saat titre edilerek esmolol uygulaması yapılmıştır.…”

Section: Discussionunclassified

Elektif Grade 3-4 Cerrahi Uygulanan Hastalarda Esmolol Kullanımının İntraoperatif Sevofluran, Fentanil Kullanımı ve Perioperatif Analjezik İlaç Tüketimine Etkisi

ÖZCAN

TANRIVERDİ

ÖZBALIK

et al. 2022

Harran Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Beta blokerlerin nonkardiyak cerrahiye giden hastalarda perioperatif kardiyak hasarı önleyebileceği gösterilmiştir. Çalışmamızın amacı; kalp dışı operasyona giden ve kardiyak olay gelişimi açısından orta-yüksek riskli hastalarda perioperatif esmolol infüzyonu kullanımının, perioperatif hemodinamiye, tüketilen inhalasyon ajanı ve narkotik madde miktarına, postoperatif tüketilen analjezik ilaç miktarına ve postoperatif yan etkilere olan etkisini araştırmaktır. Materyal ve Metod: Ocak 2012 - Temmuz 2012 tarihleri arasında, genel anestezi altında elektif üroloji ve genel cerrahi ameliyatları uygulanan ve perioperatif kardiyak olay gelişimi açısından orta-yüksek risk taşıyan 40 hasta çalışmaya dahil edildi. Esmolol grubuna, esmolol 500 µg/kg/dk 1 dakika süresince intravenöz (i.v.) yüklemesi yapılıp kalp atım hızı <80/dk olacak şekilde esmolol infüzyonu, kontrol grubuna ise aynı süre boyunca % 0,9 NaCl i.v. verildi. Bulgular: Peroperatif dönemde; esmolol grubunda ilaç yükleme sonrası kalp atım hızı (KAH) ve ortalama arter basıncı (OAB) bazal değere göre anlamlı olarak azalırken, kontrol grubunda anlamlı bir değişiklik oluşmadı. Gruplar arasında sevofluran tüketimi açısından farklılık bulunmadı, ancak esmolol grubunda ek fentanil gereksinim sıklığının anlamlı olarak daha düşük olduğu ve kullanılan fentanil miktarının anlamlı olarak daha az olduğu görüldü. Postoperatif dönemde ise; esmolol grubunda KAH ve OAB değerlerinin tüm zaman noktalarında kontrol grubuna göre anlamlı olarak daha düşük olduğu saptandı. Ancak ağrı, postoperatif morfin tüketimi, bulantı, kusma ve titreme açısından gruplar arasında herhangi bir farklılık tespit edilmedi. Sonuç: Nonkardiyak cerrahi uygulanan orta-yüksek riskli hastalarda esmolol kullanımının perioperatif ve postoperatif dönemde etkin bir hemodinamik stabilizasyon sağladığını ve perioperatif kullanılan narkotik miktarını azalttığını gösterdik. Ancak, tüketilen inhalasyon ajanı ve postoperatif kullanılan analjezik madde miktarı üzerine anlamlı bir etkisini saptayamadık.

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“…Викликає зацікавленість медичної спільно ти використання есмололу для кардіопротекції під час хірургічних втручань, як у кардіохірургії, так і опера тивних втручань інших локалізацій. Доведено, що ес молол зменшує постопераційну міокардіальну ішемію, знижує ризик великих серцевих ускладнень протягом 30 діб після втручання завдяки редукції гемодинаміч ної нестабільності [13,14,15].…”

Section: вступunclassified

Effect of short-acting b--blockers on heart rate and blood pressure in patients with acute coronary syndrome during percutaneous and coronary intervention

Распутіна¹,

Didenkо²,

Solomonchyk³

2021

prmd

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Background. The use of b- blockers in acute coronary syndrome (ACS) is recommended for all patients, who has not contraindications. The study of the effects of esmolol during percutaneous coronary intervention (PCI) remains relevant. Objective. To evaluate the features of the effect of esmolol (Biblock, “YURiA-PHARM”) on heart rate and blood pressure in patients with ACS during PCI.Materials and methods. The study included 30 patients, 15 men and 15 women, who were hospitalized in a specialized cardiology department with ACS with elevation of the ST segment. All patients underwent a general clinical examination, ECG recording in 12 leads, PCI according to the standard protocol with ECG and blood pressure monitoring. All patients were given infusion of esmolol before the standard therapy. The level of heart rate reduction, systolic blood pressure (SBP), diastolic blood pressure (DBP), the correlation of heart rate reduction during esmolol infusion with the clinical and functional parameters of patients and the degree of coronary artery (CA) damage were analyzed.Results. Decreased heart rate and blood pressure during infusion of esmolol in all patients. Before the infusion, the heart rate av-eraged (109.8 ± 4.0) beats per minute. After the infusion – (92.8 ± 3.2) beats per minute, (p < 0.001) with an average duration of infusion (18.2 ± 2.3) minutes. The decrease in SBP levels during infusion occurred on average by (22.8 ± 2.5) mm Hg, DBP – by (16.0 ± 2.1) mm Hg, no patient had hypotension. According to the results of correlation analysis, it was found that the decrease in heart rate with the use of esmolol has a correlation with the average age of patients (r = -0.47, p = 0.0012), with the presence of multivascular coronary artery disease (r = -0.38, p = 0.002). Weaker negative correlation was found with the initial level of SBP (r = -0.28, p = 0.015), the presence of a history of myocardial infarction (r = -0.27, p = 0.005), the presence of signs of left ventricular hypertrophy (LVH) on the ECG (r = -0.22, p = 0.008), and a history of arterial hypertension that was not treated according to current recommendations (r = -0.21, p = 0.032).Conclusions. The use of esmolol solution in patients with ACS who have supraventricular tachycardia and elevated blood pressure during PCI can improve control of heart rate, SBP and DBP, a significant decrease is observed after 10 minutes of dose titration. Careful titration of esmolol solution and monitoring of ECG and blood pressure revealed no side effects, including bradycardia and hypotension, which indicates a high safety profile of the drug.

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Efficacy and safety of intravenous esmolol for cardiac protection in non-cardiac surgery. A systematic review and meta-analysis

Abstract: Running head: Esmolol for cardiac protection after surgery surgery.

Cited by 15 publications

References 57 publications

Effect of Different Concentrations of Esmolol on Perioperative Hemodynamics and Analgesia in Patients Undergoing Colectomy: A Prospective, Randomized Controlled Study

Effect of Different Concentrations of Esmolol on Perioperative Hemodynamics and Analgesia in Patients Undergoing Colectomy: A Prospective, Randomized Controlled Study

Elektif Grade 3-4 Cerrahi Uygulanan Hastalarda Esmolol Kullanımının İntraoperatif Sevofluran, Fentanil Kullanımı ve Perioperatif Analjezik İlaç Tüketimine Etkisi

Effect of short-acting b--blockers on heart rate and blood pressure in patients with acute coronary syndrome during percutaneous and coronary intervention

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