Document Detail


The safety and efficacy of esmolol during myocardial revascularization.
MedLine Citation:
PMID:  3526984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The safety and efficacy of esmolol during high-dose fentanyl anesthesia were studied in 37 patients undergoing coronary artery bypass grafting (CABG). The anesthetic management consisted of fentanyl 75 micrograms/kg, pancuronium 0.15 mg/kg, and O2. To assess the safety of esmolol, it was administered in a double-blind manner to 17 anesthetized patients prior to surgical incision. Infusion of the drug was increased in stepwise fashion to obtain administration rates between 100 and 300 micrograms X kg-1 X min-1. Esmolol produced small but significant increases in pulmonary capillary wedge pressure (PCWP) (8.3 +/- 1.7 to 13.2 +/- 2.0 mmHg) when compared with placebo (10.9 +/- 1.0 to 12.1 +/- 0.6 mmHg) (P less than 0.05). For the other studied parameters (heart rate, mean arterial pressure, central venous pressure, cardiac index, stroke index, left ventricular stroke work index, systemic vascular resistance, and peripheral vascular resistance), no significant differences were observed between esmolol and placebo. To evaluate the efficacy of esmolol, 20 patients were randomly assigned to an esmolol group (n = 11) or a placebo group (n = 9). The study medication was infused from 5 min before induction through initiation of cardiopulmonary bypass. Infusion of esmolol at 200 micrograms X kg-1 X min-1 prevented tachycardia in response to intubation. In the esmolol group the heart rate increased from 63.4 +/- 2.7 to 67.6 +/- 2.9 beats/min after intubation, while in the placebo group it increased from 61.4 +/- 4.3 to 72.4 +/- 3.4 beats/min (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D Girard; B J Shulman; D M Thys; B P Mindich; S K Mikula; J A Kaplan
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  65     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1986 Aug 
Date Detail:
Created Date:  1986-09-17     Completed Date:  1986-09-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  157-64     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia
Blood Pressure / drug effects
Cardiac Output / drug effects
Clinical Trials as Topic
Coronary Artery Bypass
Double-Blind Method
Female
Fentanyl
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Kinetics
Male
Middle Aged
Myocardial Revascularization*
Propanolamines / therapeutic use*
Pulmonary Wedge Pressure / drug effects
Stroke Volume / drug effects
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Propanolamines; 437-38-7/Fentanyl; 84057-94-3/esmolol

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


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