Dupont critical care lecture: role of ultrashort-acting beta-blockers in the perioperative period.
beta-blockade can result in extreme bradycardia, significant conduction problems, bronchospasm, or left ventricular dysfunction. For this reason, the use of long-acting beta-blockers is of limited value in the perioperative period. Esmolol, due to its ultrashort action and cardioselective properties, has been shown to be safe and effective for use in treatment of tachycardia and hypertension. Doses of up to 300 microg/kg/min for up to seven hours have been used with a return to baseline parameters within 30 minutes of discontinuation of the infusion. It can also be safely used in treatment of the asthmatic patient with tachycardia or hypertension with no clinically significant increases in airway resistance. Studies using esmolol during general anesthesia have also demonstrated that it appears to have no significant interaction with various anesthetic agents.
Kaplan
J A
JA
Department of Anesthesiology, The Mt Sinai School of Medicine, New York, NY 10029, USA.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001026:Coronary Artery Bypass; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007431:Intraoperative Complications / Q000517:prevention & control*; D017202:Myocardial Ischemia / Q000517:prevention & control; D011183:Postoperative Complications / Q000188:drug therapy; D011412:Propanolamines / Q000097:blood / Q000627:therapeutic use*; D013617:Tachycardia, Supraventricular / Q000188:drug therapy
D000319:Adrenergic beta-Antagonists; D011412:Propanolamines; C036604:esmolol