title: Effect of esmolol on positive-pressure ventilation-induced variations of arterial pressure in anaesthetized humans.
abstract: Positive-pressure ventilation-induced variations in arterial pressure have been related to cardiac sympathetic activity in animals. However, the effect of beta-adrenoceptor blockade on these variations in anaesthetized humans under positive-pressure ventilation has not yet been investigated. In the present study, RAPV (respiratory-related arterial pressure variability) and %SPV (percentile systolic pressure variation) were determined before and after esmolol treatment in ten mechanically ventilated patients. RAPV and %SPV decreased significantly after intravenous esmolol (1 mg/kg of body weight) treatment (maximal decrease of RAPV, 50% and %SPV, 35%). Linear regression analysis of RAPV and %SPV before and after esmolol treatment both revealed high correlation (r = 0.93 and 0.91 respectively). The amplitudes of RAPV and %SPV also significantly increased in a graded way with higher tidal volumes. Thus we propose that esmolol suppresses the variations in arterial pressure induced by positive-pressure mechanical ventilation, and we suggest that RAPV and %SPV may be alternative choices for monitoring cardiac sympathetic regulation in anaesthetized patients under positive-pressure ventilation.
authors.affiliation: Department of Anesthesiology, Tzu Chi Buddhist General Hospital, Hualien 970, Taiwan.
authors.forename: Hsien Yong
authors.initials: HY
authors.lastname: Lai
authors.forename: Cheryl C H
authors.initials: CC
authors.lastname: Yang
authors.forename: Ching-Feng
authors.initials: CF
authors.lastname: Cheng
authors.forename: Fan Yen
authors.initials: FY
authors.lastname: Huang
authors.forename: Yi
authors.initials: Y
authors.lastname: Lee
authors.forename: Ming-Hwang
authors.initials: MH
authors.lastname: Shyr
authors.forename: Terry B J
authors.initials: TB
authors.lastname: Kuo
mesh_terms: D000319:Adrenergic beta-Antagonists; D000768:Anesthesia, General; D001341:Autonomic Nervous System / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D003864:Depression, Chemical; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016014:Linear Models; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011175:Positive-Pressure Respiration; D011412:Propanolamines; D012119:Respiration; D012815:Signal Processing, Computer-Assisted; D013599:Systole; D013990:Tidal Volume
chemical_list: D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; C036604:esmolol