PURPOSE: Patients with increased intracranial pressure (ICP) are prone to severe cardiac and or cerebral complications following emergence from general anesthesia and especially post-extubation phase. Administering beta blockers including esmolol is believed to be helpful in providing a stable hemodynamic at the end of the surgery and recovery stages and reducing recovery phase length. METHOD: In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving esmolol (n=30) and placebo (n=30) as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation. RESULT: There was a significant difference between two groups regarding the changes of systolic blood pressure and heart rate at all studied stages after extubation (P≤0.05). However, no significant difference existed between esmolol and control groups regarding recovery and extubation times emphasizing the fact that esmolol is of excellent early recovery and extubation profiles. CONCLUSION:Esmolol is advised to be used in preventing hyperdynamic status throughout extubation phase without extending recovery phase length.
RCT Entities:
PURPOSE:Patients with increased intracranial pressure (ICP) are prone to severe cardiac and or cerebral complications following emergence from general anesthesia and especially post-extubation phase. Administering beta blockers including esmolol is believed to be helpful in providing a stable hemodynamic at the end of the surgery and recovery stages and reducing recovery phase length. METHOD: In a double-blind prospective randomized clinical trial, 60 adult patients with ASA (American Society of Anesthesiologist) class of I-II scheduled to undergo elective neurosurgery operations were randomly divided into two groups receiving esmolol (n=30) and placebo (n=30) as IV infusion within four minutes prior to extubation continued by an IV infusion for 10 minutes after extubation. RESULT: There was a significant difference between two groups regarding the changes of systolic blood pressure and heart rate at all studied stages after extubation (P≤0.05). However, no significant difference existed between esmolol and control groups regarding recovery and extubation times emphasizing the fact that esmolol is of excellent early recovery and extubation profiles. CONCLUSION:Esmolol is advised to be used in preventing hyperdynamic status throughout extubation phase without extending recovery phase length.
Authors: J Guy; B J Hindman; K Z Baker; C O Borel; M Maktabi; N Ostapkovich; J Kirchner; M M Todd; P Fogarty-Mack; V Yancy; M D Sokoll; A McAllister; C Roland; W L Young; D S Warner Journal: Anesthesiology Date: 1997-03 Impact factor: 7.892
Authors: Federico Bilotta; Arthur M Lam; Andrea Doronzio; Vincenzo Cuzzone; Roberto Delfini; Giovanni Rosa Journal: J Clin Anesth Date: 2008-09 Impact factor: 9.452