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

Abstract

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 .

The Effect of Pre-Intubation Esmolol and Dexmedetomidine on Ischemia Modified Albumin Levels: A Prospective Randomized Trial

“…Future studies aiming to elucidate ischemic conditions which can be caused by sympatholytic agents used to suppress hemodynamic response to intubation should focus on optimal dosage, technique and timing using advanced hemodynamic monitorization techniques and tissue specific biomarkers. 0.5 and 1 mg kg -1 esmolol administered before intubation effectively suppressed hemodynamic response to intubation (13). Similarly, Erbesler et al have stated that 0.5 mg kg -1 esmolol and 0.5 μg kg -1 dexmedetomidine given 10 minutes before induction resulted in similar hemodynamic outcomes (14).…”