Document Detail

Hypotensive anesthesia with esmolol. Assessment of hemodynamics, consumption of anesthetic drugs, and recovery.
MedLine Citation:
PMID:  19526158     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the effect of esmolol added to propofol-remifentanil combination for hypotensive anesthesia on hemodynamic conditions, consumption of anesthetic drugs, and recovery, during elective septorhinoplasty. METHODS: This prospective, randomized study was carried out at Gazi University, Faculty of Medicine, Ankara, Turkey in 2005. Following Institutional Ethical Committee approval, 40 American Society of Anesthesiologists (ASA) I patients were divided into 2 equal groups group remifentanil infusion RP and group esmolol infusion (RP-E). After anesthesia induction with propofol (2-2.5 mg/kg), the mean arterial pressure was aimed to be between 50 mm Hg and 65 mm Hg for controlled hypotensive anesthesia in both groups. In group RP, a remifentanil infusion of 0.1-0.5 microg/kg/min was titrated, following a bolus of 1 microg/kg; for group RP-E, an esmolol infusion of 100-300 mg/kg/min was titrated, following a bolus of 500 microg/kg; to achieve a target blood pressure. In addition, propofol was infused according to depth of anesthesia to maintain anesthesia in both groups. Electrocardiography, heart rate, blood pressure, cardiac output, and consumption of anesthetic drugs were recorded. Postoperatively, recovery times, visual analog pain scores, and side effects were observed. RESULTS: The decrease in the intraoperative heart rate was more significant in group RP-E than in group RP. The remifentanil consumption was much lower in group RP-E. The recovery times were similar in both groups. CONCLUSION: Addition of esmolol to propofol-remifentanil combination leads to a decrease in remifentanil consumption, without a decrease in cardiac output during hypotensive anesthesia.
Biricik M Gökçe; Lale Karabiyik; Yener Karadenizli
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Saudi medical journal     Volume:  30     ISSN:  0379-5284     ISO Abbreviation:  Saudi Med J     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-15     Completed Date:  2009-08-31     Revised Date:  2009-10-31    
Medline Journal Info:
Nlm Unique ID:  7909441     Medline TA:  Saudi Med J     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  771-7     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care, Baskent University School of Medicine, Ankara, Turkey.
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MeSH Terms
Anesthetics / administration & dosage,  pharmacology*
Hemodynamics / drug effects*
Hypotension / chemically induced*
Middle Aged
Piperidines / administration & dosage,  pharmacology*
Propanolamines / administration & dosage,  pharmacology*
Propofol / administration & dosage,  pharmacology,  therapeutic use*
Young Adult
Reg. No./Substance:
0/Anesthetics; 0/Piperidines; 0/Propanolamines; 132875-61-7/remifentanil; 2078-54-8/Propofol; 84057-94-3/esmolol

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