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Anesth Analg 1986; 65:451-456
© 1986 International Anesthesia Research Society
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Esmolol Attenuates Hemodynamic Responses during Fentanyl-Pancuronium Anesthesia for Aortocoronary Bypass Surgery

Lars R. Newsome, MD, Jonathan V. Roth, MD, Carl C. Hug, Jr, MD, PhD, and David Nagle, MMSc

Received from the Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia.

Abstract

We evaluated the effects of esmolol, a short acting (t1/2 ß = 9 min) ß-blocker on hemodynamics during noxious stimulation associated with aortocoronary bypass surgery. Group E (n = 10) and P (n = 10) patients had their morning dose of ß- or calcium blockers withheld except for nifedipine, and were given infusions of esmolol (E) or placebo (P) beginning prior to anesthetic induction and continuing until mediastinal dissection. Group S (n = 10) patients received their usual medication the morning of surgery and received neither esmolol nor placebo. All patients received fentanyl infusions for anesthesia and pancuronium for relaxation.

Esmolol patients had no changes in heart rate throughout the study. In contrast, significant increases in heart rate occurred during induction, intubation, and surgical stimulation in Groups P and S. Esmolol patients had a statistically significant but transient increase in pulmonary capillary wedge pressure (PCWP) after intubation, which did not require treatment. There were no significant changes in PCWP in Group S and a decrease in PCWP in Group P patients. We conclude that esmolol was effective in attenuating potentially deleterious responses to noxious stimulation during fentanyl-pancuronium anesthesia.

Key Words: ANESTHESIA, CARDIOVASCULAR • SYMPATHETIC NERVOUS SYSTEM, PHARMACOLOGY—esmolol






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1986 by the International Anesthesia Research Society.