Document Detail


Effects of esmolol on haemodynamic response to CO2 pneumoperitoneum for laparoscopic surgery.
MedLine Citation:
PMID:  9605365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Carbon dioxide (CO2) pneumoperitoneum for laparoscopic surgery increases arterial pressures, systemic vascular resistance and heart rate and decreases urine output. METHODS: In this double-blind randomized study esmolol, an ultrashort-acting beta1-adrenoceptor antagonist was compared with physiological saline (control) in 28 patients undergoing laparoscopic surgery in standardized 1 MAC isoflurane anaesthesia. Alfentanil infusion was used to prevent the increase of mean arterial pressure more than 25% from baseline. RESULTS: Esmolol effectively prevented the pressor response to induction and maintenance of CO2 pneumoperitoneum. Significantly (P<0.001) less alfentanil was needed in the esmolol group than in the control group. Urine output was higher (P<0.05) and plasma renin activity (P<0.01) and urine N-acetyl-beta-D-glucosaminidase levels lower in the esmolol group when compared with the control group. CONCLUSIONS: Esmolol blunts the pressor response to induction and maintenance of pneumoperitoneum and may protect against renal ischaemia during pneumoperitoneum.
Authors:
A M Koivusalo; M Scheinin; I Tikkanen; T Yli-Suomu; S Ristkari; J Laakso; L Lindgren
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  42     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-07-23     Completed Date:  1998-07-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  510-7     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
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MeSH Terms
Descriptor/Qualifier:
Acetylglucosaminidase / urine
Adrenergic beta-Agonists / administration & dosage,  therapeutic use*
Adult
Alfentanil / administration & dosage
Anesthetics, Inhalation / administration & dosage
Anesthetics, Intravenous / administration & dosage
Blood Pressure / drug effects
Carbon Dioxide*
Double-Blind Method
Female
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Ischemia / prevention & control
Isoflurane / administration & dosage
Kidney / blood supply
Laparoscopy*
Male
Middle Aged
Pneumoperitoneum, Artificial*
Propanolamines / administration & dosage,  therapeutic use*
Renin / blood
Sodium Chloride
Urine
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Propanolamines; 124-38-9/Carbon Dioxide; 26675-46-7/Isoflurane; 71195-58-9/Alfentanil; 7647-14-5/Sodium Chloride; 84057-94-3/esmolol; EC 3.2.1.52/Acetylglucosaminidase; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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