Efficacy of Intrathecal Esmolol on Heat-Evoked Responses in a Postoperative Pain Model

Abstract

Perioperative tachycardia and hypertension are often treated with esmolol, a short-acting β1-adrenoceptor antagonist. Besides its cardiac effect, esmolol is reported to exert antinociceptive effects. This study examined the efficacy of intrathecal (IT) esmolol on pain responses in a postoperative pain model. Male Sprague-Dawley rats (250-300 g) were anesthetized with sevoflurane and an IT catheter was implanted. Six days after catheter implantation, a postoperative pain model was established by plantar incision under sevoflurane anesthesia. Withdrawal latencies were assessed by applying a focused radiant heat source before plantar incision; 1 day after the incision (before esmolol administration); and 5, 10, and 15 minutes after bolus administration of IT esmolol. Plantar incision produced hypersensitivity in the postoperative pain model expressed as decreased withdrawal latency to heat stimulation (before incision: 13.9 ± 0.29 seconds and 1 day after incision: 6.3 ± 0.26 seconds). These decreased latencies caused by incision were significantly increased by esmolol administration (40 μg, 80 μg) at 5 minutes (10.7 ± 1.16 seconds, 10.5 ± 1.16 seconds). No postoperative antinociceptive effects of esmolol were observed at 10 or 15 minutes. IT administration of esmolol produced antinociceptive effects of short duration in a rat postoperative pain model. These results suggest that IT esmolol could offer a new strategy for managing perioperative pain, although an alternative approach is necessary to lengthen the duration of the analgesia.

Esmolol infusion reduces blood loss and opiate consumption during fertility preserving myomectomy

“…Interestingly, patients received esmolol infusion consumed significantly lower dose of IO and PO fentanyl; a finding suggesting an analgesic effect for esmolol. These findings go in hand with Ono et al [35] who experimentally, found intrathecal administration of esmolol produced antinociceptive effects of short duration in a rat PO pain model. Clinically, Lee et al [36] found pretreatment with esmolol or remifentanil equally decreased pain during propofol injection with no significant differences in pain incidence or severity.…”

Effect of Intravenous Intraoperative Esmolol on Pain Management Following Lower Limb Orthopedic Surgery

“…It has been shown that esmolol, as a selective short-acting antagonist, has analgesic effects in addition to cardiovascular effects. For example, the study by Ono and colleagues showed that intrathecal administration of esmolol had analgesic effects on postoperative pain in animals [ 4 ]. Bhawna and his colleagues showed that esmolol can reduce the need for opioids after abdominal surgery [ 5 ].…”

The therapeutic potential of ultra-short-acting β-receptor antagonists in perioperative analgesic: Evidence from preclinical and clinical studies

“…A report on in vivo administration of esmolol alone explored the effect of intrathecal administration in a postoperative pain model ( Ono et al, 2015 ). The postoperative pain model was established with the use of a plantar incision.…”