Author/Authors :
Sultan, Sherif S. Ain Shams University - Faculty of Medicine - Department of Anesthesia and Intensive Care, Egypt
Abstract :
ContextAmbulatory surgery has a target of rapid recovery and discharge. Esmolol has sparing effectson inhalational anesthetics and opioids.AimThe aim of the study was to demonstrate effects of esmolol infusion on recovery profile anddischarge from postanesthesia care unit (PACU).Settings and designThis study was a randomized, double-blind, and controlled study.Patients and methods Sixty female patients scheduled for elective gynecologic laparoscopic surgery under generalanesthesia were divided into two groups. Patients were given either esmolol loading and maintenance doses (the esmolol group) or equivalent volume of normal saline (the controlgroup). Esmolol was given as a loading dose of 1 mg/kg just before induction of anesthesia followed by an infusion of 30 μg/kg/min. Depth of anesthesia was controlled by bispectral index monitoring and variable dose propofol infusion, whereas fentanyl and sevofl urane doses were fixed throughout the procedure. Times denoting recovery from anesthesia were recorded.Patients who reached White–Song score of 12 plus pain numerical rating scale below 4 were discharged from PACU. Time needed for PACU discharge was recorded.Results Compared with the control group, the esmolol group had following statistically signifi cant results:lower blood pressure and heart rate, less fluctuant bispectral index values, lower amount of propofol infusion used, shorter times for immediate post operative eye opening, extubation,tongue protrusion, and ability of the patient to mention her name, lower pain scores, fewerpatients needed analgesics and earlier discharge from PACU.Conclusion Intraoperative esmolol infusion is associated with hemo dynamic stability and antinociceptive properties. Recovery profile was excellent and helped early discharge from PACU.
