title: Effect of Intravenous Intraoperative Esmolol on Pain Management Following Lower Limb Orthopedic Surgery.
abstract: BACKGROUND
  Lack of proper control of acute postoperative pain often leads to lingering or chronic pain. Several studies have emphasized the role of beta-blockers in reducing postoperative pain. Esmolol is a selective short-acting beta-blocker that produces few side effects. The purpose of this study was to examine the effect of intravenous intraoperative esmolol on postoperative pain reduction following orthopedic leg fracture surgery.
  
  
  METHODS
  In a clinical trial, 82 patients between 20-65 years of age with tibia fractures and American Society of Anesthesiologists (ASA) physical status I & II who underwent surgery were divided into two groups. Group A received esmolol and group B received normal saline. Postoperative pain was measured at three time points: entering the recovery unit, and at 3 h and 6 h following surgery, using the Visual Analogue Scale (VAS). A P value of < 0.05 was considered significant.
  
  
  RESULTS
  Mean VAS scores at all three time points were significantly different between the two test groups (P = 0.02, P = 0.0001, and P = 0.0001, respectively). The consumption of pethidine was lower in group A than in group B (P = 0.004) and the duration of its effect was significantly longer in time (P = 0.026).
  
  
  CONCLUSIONS
  Intravenous intraoperative esmolol is effective in the reduction of postoperative pain following leg fracture surgery. It reduced opioid consumption following surgery and delayed patient requests for analgesics.
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Haghighi
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Sedighinejad
authors.affiliation: Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Mirbolook
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Naderi Nabi
authors.affiliation: Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Maral
authors.initials: M
authors.lastname: Farahmand
authors.affiliation: Guilan Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Kazemnezhad Leili
authors.affiliation: Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Shirvani
authors.affiliation: Qazvin University of Medical Sciences, Qazvin, Iran.
authors.forename: Sina
authors.initials: S
authors.lastname: Khajeh Jahromi
keywords: Esmolol; Meperidine; Orthopedic surgery; Pain management; Pain measurement; Postoperative pain; Tibial fractures; Visual analog scale