Document Detail


The safety and effectiveness of esmolol in the perioperative period in patients undergoing abdominal aortic surgery.
MedLine Citation:
PMID:  10527224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine (1) if perioperative use of esmolol in major vascular surgery patients provides strict heart rate (HR) control, (2) what doses of esmolol are required to do this, and (3) does this control influence myocardial ischemia or result in adverse consequences. DESIGN: Prospective study of 40 patients randomized to two groups: The HR was controlled to either less than 80 beats/min (group 80) or less than 110 beats/min (group 110) using esmolol. Patients were monitored continuously for electrocardiographic changes perioperatively. HR control began after induction of anesthesia and continued for 48 hours thereafter. SETTING: Operating room and intensive care unit. PATIENTS: Patients undergoing abdominal vascular surgery involving aortic cross-clamping. INTERVENTIONS: Esmolol was titrated until the target HR was met. MEASUREMENTS AND RESULTS: Only one patient demonstrated an adverse effect. The median infusion rates were 100 and 12.5 microg/kg/min for groups 80 and 110. Target HR was met less in group 80 than in group 110, primarily in the postoperative period. Ischemia patterns were not significantly different between groups. CONCLUSION: Using esmolol for HR control in the intraoperative period for abdominal vascular surgery patients is effective and safe. HR control was much less effective in the postoperative period, but esmolol is safe when used at recommended doses. Further study with a larger number of patients is necessary to determine whether strict HR control with esmolol affects the incidence of myocardial ischemia or infarction in this patient population.
Authors:
T N Harwood; J Butterworth; R C Prielipp; R L Royster; K Hansen; G Plonk; R Dean
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  13     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-18     Completed Date:  1999-11-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  555-61     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and General Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1009, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / adverse effects,  therapeutic use*
Aged
Aorta, Abdominal / surgery*
Electrocardiography
Female
Heart Rate / drug effects
Humans
Intraoperative Complications / prevention & control
Intraoperative Period
Male
Middle Aged
Monitoring, Intraoperative
Myocardial Ischemia / prevention & control
Postoperative Complications / prevention & control
Propanolamines / adverse effects,  therapeutic use*
Prospective Studies
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Propanolamines; 84057-94-3/esmolol

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


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