The influence of esmolol on the dose of propofol required for induction of anaesthesia*

Abstract

SummaryCardiac output may be an important determinant of the induction dose of intravenous anaesthetic. Esmolol is known to reduce cardiac output, and we examined its effect on the propofol dose required for induction of anaesthesia. The size of the effect seen with esmolol was compared with midazolam co-induction. Sixty patients were randomly allocated to placebo (saline), esmolol (1mg.kg )1 bolus, followed by an infusion at 250 lg.kg) or midazolam (0.04 mg.kg )1 ) groups. Induction of anaesthesia commenced 3 min following the administration of the study drug, using a Diprifusor set to achieve plasma propofol concentrations of 10 lg.mlat 5 min. The primary end point used was the propofol dose per kg at loss of response to command. The mean (SD) propofol dose for each group was 2.38 (0.48) mg.kg )1 for placebo,

Une perfusion de dopamine diminue la concentration de propofol pendant le bloc péridural sous anesthésie générale

“…Upton et al 6 reported that the initial arterial concentration of propofol after a short infusion was inversely related to CO in sheep. 15 No investigations, however, have assessed the influence of changing CO on propofol concentrations during constant rate infusion in humans. Epidural anesthesia has been reported as exerting no influence on the pharmacokinetics of propofol.…”

Intrathecal landiolol inhibits nociception and spinal c-Fos expression in the mouse formalin test

“…Although further studies exploring the detailed mechanism are needed, these data suggest a potential role of β 1 -adrenoreceptors in spinal nociceptive processing. [1][2][3][4] In addition, the sedative properties of these compounds may decrease anesthetic requirements [5][6][7][8] and reduce bispectral index, a value reflecting activity of the cerebral cortex and levels of consciousness. 3 In recent years, there have been several reports identifying the antinociceptive and analgesic effects of β 1 -blockers in both animal and human studies.…”

“…[1][2][3][4] The advantages of using landiolol in clinical anesthesia include that it is very short-acting and highly selective for β 1 receptors, 11 thus rendering easy titration and less side effects such as asthma or peripheral vasoconstriction compared to other longer-acting β blockers. As landiolol is metabolized very quickly by serum pseudochorinesterase and carboxyesterase in the liver to an inactive metabolite with a short half-life, it is reasonable to assume that most of the intrathecal landiolol will undergo decomposition and excretion before the drug diffuses into the blood and takes systemic pharmacological effect.…”

Bir grup laparoskopik kolesistektomi hastasında intraoperatif esmolol infüzyonunun postoperatif stres yanıt üzerine etkisi

“…They compared effect of esmolol addition on propofol and 60% N2O requirements and observed that esmolol significantly decreases requirements for both agents 5 . In two different studies Topçu and colleagues and Wilson and colleagues reported esmolol decreased both propofol and remifentanil requirements 30,31 .…”