[The use of short-acting beta-blockers in cardiac surgery].
Ultra-short-acting beta-blockers play an important role in perioperative control of blood pressure, particularly in situations requiring rapid reversibility of effects. Esmolol seems to offer many desirable effects of beta-blockers, in addition to a short half-life and rapid finalization of effect. Combined therapy with vasodilators provides optimum hemodynamic control in most cases.Ultra-short action beta-blockers have proven effective for the control of arrhythmias, particularly for tachycardias of the narrow complex. The future may bring applications such as desensitization of beta-adrenergic receptors, associated with reaction to stress during cardiac surgery. The role of beta-blockers in primary myocardial protection against ischemic lesions is being investigated.
Van Besouw
J
J
Consultant in Cardiothoracic Anaesthesia, St. George's Hospital, Londres, Reino Unido. jpvb@gas.mailbox.co.uk
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001013:Aorta, Thoracic / Q000601:surgery; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006348:Cardiac Surgical Procedures; D002314:Cardioplegic Solutions; D002395:Catecholamines / Q000378:metabolism; D004359:Drug Therapy, Combination; D005112:Extracorporeal Circulation; D006207:Half-Life; D006321:Heart / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D007431:Intraoperative Complications / Q000188:drug therapy*; D009206:Myocardium / Q000378:metabolism; D011183:Postoperative Complications / Q000188:drug therapy*; D011412:Propanolamines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D013312:Stress, Physiological / Q000503:physiopathology; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002314:Cardioplegic Solutions; D002395:Catecholamines; D011412:Propanolamines; D014665:Vasodilator Agents; C036604:esmolol