Abstract
The effectiveness of esmolol, an ultra short-acting cardioselective β blocker, in the prevention and treatment of post-intubation haemodynamic perturbations, was investigated. Forty-eight ASA physical status I and II patients undergoing hysterectomy were randomly assigned to receive a single intravenous bolus of placebo, esmolol 100 mg, or esmolol 200 mg in a double-blind fashion. This was administered over 15 sec, and immediately followed by thiopentone 3–5 mg · kg- 1, succinylcholine 1.5 mg · kg- 1, and tracheal intubation 90 sec later. The heart rate following induction of anaesthesia was lower in the esmolol 200 mg group (P < 0.01); following intubation, the increase in heart rate in the placebo group was greater than in the esmolol groups (P < 0.05). The systolic blood pressure post-induction was lower in the esmolol 200 mg group (P < 0.05); following intubation, however, no significant differences were seen among groups in systolic, diastolic, or mean blood pressures. Following tracheal intubation, the incidence of ventricular arrythmias was lower in the esmolol groups (P < 0.05). In summary, esmolol in 100 mg and 200 mg doses was effective in mitigating the haemodynamic response following tracheal intubation.
Résumé
L’efficacité de l’esmolol, dans la prevention et le traitement des variations hémodynamiques lors de l’intubation a été investiguee. Quarante-huit patientes ASA I et II devant subir une hystérectomie étaient randomisées afin de recevoir soit un bolus de placebo, soit 100 mg ou 200 mg d’esmolol à double insu. L’administration intraveineuse s’est faite sur 15 secondes immediatement après du thiopentone 3–5 mg · kg- 1, succinylcholine 1,5 mg · kg- 1 et intubation trachéale 90 sec. plus tard. Lafréquence cardiaque après induction de l’anesthésie ’etait plus basse dans le groupe esmolol 200 mg (P < 0,01); après l’intubation, l’augmentation de lafréquence cardiaque dans le groupe placebo était plus grande que celle des groupes esmolol (P < 0,05). La pression artérielle systolique après l’induction était plus basse dans le groupe esmolol 200 mg (P < 0,05); après l’intubation, cependant, il n’y avail aucune différence significative entre le groupe dans la pression artérielle systolique, diastolique ou la pression artérielle moyenne. Après intubation trachéale, l’incidence d’arythmie ventriculaire était plus basse dans les groupes esmolol (P < 0,05). En résumé, des doses desmolol de 100 mg et 200 mg étaient efficaces pour atténuer la réponse hémodynamique après intubation endotrachéale.
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Oxorn, D., Knox, J.W.D. & Hill, J. Bolus doses of esmolol for the prevention of perioperative hyper-tension and tachycardia. Can J Anaesth 37, 206–209 (1990). https://doi.org/10.1007/BF03005471
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DOI: https://doi.org/10.1007/BF03005471