Abstract
Forty-five patients of ASA physical status 1 and II undergoing a variety of non-cardiac surgical procedures were studied to determine the effect of bolus administration of esmolol, a new short-acting beta blocking drug, on heart rate and blood pressure responses to induction of anaesthesia and tracheal intubation. Subjects were allocated randomly to receive placebo, 100 mg or 200 mg of esmolol IV as part of an anaesthetic induction technique. The differences in heart rate between the placebo group and both the 100 mg and 200 mg groups were significant prior to intubation (95 ± 7.9, 82 ± 9.7, 80 ± 7.3 beats per min respectively), and also at 0.5 min and 1.5 min following intubation for the 200 mg group. In the 200 mg group there was a significant decrease, compared with placebo, in systolic blood pressure at 0.5 min (144 ± 32.1 vs 165 ± 18.7 mmHg) and 1.5 min (154 ± 25.0 vs 170 ± 19.5 mmHg) after intubation. In this study, adequate haemodynamic control was obtained following administration of 200 mg of esmolol.
Résumé
Quarante-cinq patients ASA classe I et II devant subir une variété de procédures chirurgicales non-cardiaques ont été étudiés afin de déterminer l’effet de l’administration de l’esmolol en bolus sur la fréquence cardiaque et la tension artérielle lors de l’induction de l’anesthesie et l’intubation endotrachéale. Les sujets ont été randomisés afin de recevoir soit du placebo, soit 100 mg ou 200 mg d’esmolol lors de l’induction. Les différences dans la fréquence cardiaque entre le groupe placebo et les deux groupes de 100 mg et 200 mg etaient significatives avant l’intubation (95 ± 7,9, 82 ± 9,7, 80 ± 7,3 battlminute respectivement), et aussi à 0,5 minutes et 1,5 minutes après l’ intubation pour le groupe de 200 mg. Pour le groupe 200 mg, il y avait une diminution significative (comparativement au placebo) dans la pression artérielle systolique à 0,5 minutes (144 ± 32,1 versus 165 ± 18,7 mmHg) et à 1,5 minutes (154 ± 25,0 versus 170 ± 19,5 mmHg) après intubation. Dans cette etude, un contrôle hémodynamique adéquat était obtenu aprés administration de 200 mg d’esmolol.
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References
Benfield P, Sorkin EM. Esmolol: a preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs 1987; 33: 392–412.
Anderson S, Blanski L, Byrd RC et al. Comparison of the efficacy and safety of esmolol, a short-acting beta blocker, with placebo in the treatment of supraventricular tachyarrythmias. Am Heart J 1986; 111: 42–8.
Gray RJ, Bateman TM, Czer LSC et al. Esmolol: a new ultrashort-acting beta-adrenergic blocking agent for rapid control of heart rate in postoperative supraventricular tachyarrhythmias. J Am Coll Card 1985; 5: 1451–6.
Gray RJ, Bateman TM, Czer LSC et al. Use of esmolol in hypertension after cardiac surgery. Am J Cardiol 1985; 56: 49F-56F.
Henling CE, Reves JG, Samuelson PN et al. Hemodynamic effects of continuous infusion of esmolol during cardiac operation. Anesth Analg 1986; 65: S70.
Zakowski M, Kaufman B, Berguson P et al. Esmolol use during resection of pheochromocytoma: report of three cases. Anesthesiology 1989; 70: 875–7.
Liu PL, Statt S, Gugino LD et al. Esmolol for control of increases in heart rate and blood pressure during tracheal intubation after thiopentone and succinylcholine. Can Anacsth Soc J 1986; 33: 556–62.
Miller DR, Martineau, RJ. Esmolol for control of haemodynamic responses during anaesthetic induction. Can J Anaesth 1989; 36: S164–5.
Stoelting RK. Blood pressure and heart rate changes during short-duration laryngoscopy for tracheal intubation: influence of viscous or intravenous lidocaine. Anesth Analg 1978; 57: 197–9.
Denlinger JK, Ellison N, Ominsky AJ. Effects of intratracheal lidocaine on circulatory responses to tracheal intubation. Anesthesiology 1974; 41: 409–12.
Martin DE, Rosenberg H, Aukburg SJ et al. Low-dose fcntanyl blunts circulatory responses to tracheal intubation. Anesth Analg 1982; 61: 680–4.
Stoelting RK. Attenuation of blood pressure response to laryngoscopy and tracheal intubation with sodium nitroprusside. Anesth Analg 1979; 58: 116–9.
Cohn PF. Silent myocardial ischemia. Ann Intern Med 1988; 109: 312–7.
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This research was supported by a grant from DuPont Pharmaceuticals.
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Sheppard, S., Eagle, C.J. & Strunin, L. A bolus dose of esmolol attenuates tachycardia and hypertension after tracheal intubation. Can J Anaesth 37, 202–205 (1990). https://doi.org/10.1007/BF03005470
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DOI: https://doi.org/10.1007/BF03005470