Bolus doses of esmolol for the prevention of perioperative hyper-tension and tachycardia

Abstract

The effectiveness of esmolol, an ultra short-acting cardioselective β blocker, in the prevention and treatment of post-intubation haemodynamic perturbations, was investigated. Forty-eight ASA physical status I and II patients undergoing hysterectomy were randomly assigned to receive a single intravenous bolus of placebo, esmolol 100 mg, or esmolol 200 mg in a double-blind fashion. This was administered over 15 sec, and immediately followed by thiopentone 3-5 mg · kg- 1, succinylcholine 1.5 mg · kg- 1, and tracheal intubation 90 sec later. The heart rate following induction of anaesthesia was lower in the esmolol 200 mg group (P < 0.01); following intubation, the increase in heart rate in the placebo group was greater than in the esmolol groups (P < 0.05). The systolic blood pressure post-induction was lower in the esmolol 200 mg group (P < 0.05); following intubation, however, no significant differences were seen among groups in systolic, diastolic, or mean blood pressures. Following tracheal intubation, the incidence of ventricular arrythmias was lower in the esmolol groups (P < 0.05). In summary, esmolol in 100 mg and 200 mg doses was effective in mitigating the haemodynamic response following tracheal intubation. © 1990 Canadian Anesthesiologists.