The effect of perioperative esmolol on early postoperative pain: A systematic review and meta-analysis

Watts, Richard W.; Thiruvenkatarajan, Venkatesan; Calvert, Marni; Newcombe, G.; Wijk, Roelof Van

doi:10.4103/0970-9185.202182

Cited by 37 publications

(28 citation statements)

References 42 publications

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“…In this study, analgesia was improved with esmolol, both during surgery and in the postoperative period over 24 hours, which can be considered a good effect of this drug. This result is similar to report in the literature focusing on other types of surgeries and patients with BMI within the normal range [6,8,20].…”

Section: Discussionsupporting

confidence: 91%

Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Morais

Sakata

Huang

et al. 2019

Preprint

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Background Patients undergoing bariatric surgery can have respiratory complications in addition to vomiting and ileus. Esmolol can decrease the consumption of opioids, reducing their side effects. The purpose of this study was to evaluate the analgesic effect of esmolol in patients allocated to laparoscopic gastroplasty. Methods Forty patients between 18 and 50 years old, of both genders, physical status ASA I-II, who underwent bypass gastroplasty were divided into two groups. Participants in group 1 received a 0.5 mg/kg bolus of esmolol in 30 mL of saline before induction of anesthesia, followed by infusion of 15µg/kg/min until the end of surgery; those in group 2 received 30 mL of saline bolus and infusion of solution in the same volume as group 1. The anesthesia included fentanyl (5ug/kg), propofol (2-4 mg/kg), rocuronium (0.6 mg/kg), 50% oxygen without nitrous oxide and 2% sevoflurane, with remifentanil if necessary. There were evaluated: remifentanil consumption, time to analgesic supplementation, pain intensity for 24 h and morphine dose over 24 h. Side effects were noted. Results Intraoperative remifentanil supplementation, time to recovery, and postoperative morphine supplementation were lower in the esmolol group; there was no difference in time for the first supplementation. Pain intensity was lower, except at T0 and after 12 h. There were no differences in side effects. Conclusions Intraoperative esmolol promotes an analgesic effect without causing adverse effects, making it an effective drug for multimodal analgesia for gastroplasty.

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Section: Discussionsupporting

confidence: 91%

Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Morais

Sakata

Huang

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…In this study, analgesia was improved with esmolol, both during surgery and in the postoperative period over 24 hours. This result is similar to literature on other types of surgeries and patients with BMI within the normal range 8,9,13 .…”

Section: ■ Discussionsupporting

confidence: 91%

Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

et al. 2020

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To evaluate the analgesic effect of esmolol in patients submitted to laparoscopic gastroplasty. Methods: Forty patients aged between 18 and 50 years with American Society of Anesthesiologists (ASA) physical status scores of II and III who underwent gastric bypass were allocated to two groups. Group 1 patients received a 0.5-mg/kg bolus of esmolol in 30 mL of saline before induction of anesthesia, followed by an infusion at 15 µg/kg/min until the end of surgery. Group 2 patients received 30 mL of saline as a bolus and then an infusion of saline. Anesthesia included fentanyl (3 µg/kg), propofol (2-4 mg/kg), rocuronium (0.6 mg/kg), and 2% sevoflurane, with remifentanil if necessary. The following parameters were evaluated: pain intensity over 24h, remifentanil consumption, the first analgesic request, morphine consumption, and side effects. Results: Pain intensity was lower in the esmolol group except at T0 (after extubation) and 12h postoperatively. Remifentanil supplementation, recovery time, and postoperative morphine supplementation were lower in the esmolol group. No differences in the time to the first analgesic request or side effects were found between the groups. Conclusion: Intraoperative esmolol promotes reductions in pain intensity and the need for analgesic supplementation without adverse effects, thus representing an effective drug for multimodal analgesia in gastroplasty.

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“…Administered opioids could be of different types and potencies. Therefore, Morphine Milligram Equivalent (MME) representation was used to consolidate the opioid doses into a single normalized value [26][27][28]. The MME conversion ratios used for the study are tabulated in S1 Table. Numeric MME values are less practical to interpret and act in a clinical setting than categories of opioid requirements that correspond to pain levels.…”

Section: Plos Onementioning

confidence: 99%

Machine learning approach to predict postoperative opioid requirements in ambulatory surgery patients

Nair¹,

Velagapudi

Lang

et al. 2020

PLoS ONE

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Opioids play a critical role in acute postoperative pain management. Our objective was to develop machine learning models to predict postoperative opioid requirements in patients undergoing ambulatory surgery. To develop the models, we used a perioperative dataset of 13,700 patients (� 18 years) undergoing ambulatory surgery between the years 2016-2018. The data, comprising of patient, procedure and provider factors that could influence postoperative pain and opioid requirements, was randomly split into training (80%) and validation (20%) datasets. Machine learning models of different classes were developed to predict categorized levels of postoperative opioid requirements using the training dataset and then evaluated on the validation dataset. Prediction accuracy was used to differentiate model performances. The five types of models that were developed returned the following accuracies at two different stages of surgery: 1

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The effect of perioperative esmolol on early postoperative pain: A systematic review and meta-analysis

Cited by 37 publications

References 42 publications

Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Randomized, double-blind, placebo-controlled study of the analgesic effect of intraoperative esmolol for laparoscopic gastroplasty

Machine learning approach to predict postoperative opioid requirements in ambulatory surgery patients

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