Repair of traumatic transection of the thoracic aorta: esmolol for intraoperative control of arterial pressure.

We report the intraoperative use of esmolol for control of arterial pressure during repair of a traumatic transection of the descending thoracic aorta. A mean infusion rate of esmolol 50.5 micrograms kg-1 min-1 resulted in a decrease in mean arterial pressure to 63 mm Hg and heart rate to 99 beat min-1 and was associated with excellent surgical conditions. The infusion rate of esmolol was titrated easily against mean arterial pressure, which increased rapidly on discontinuing its infusion. Control of arterial pressure with esmolol was comparable to that achieved with sodium nitroprusside, but without the reflex tachycardia or decrease in Pao2 associated with the latter agent.