Effect of intravenous esmolol on analgesic requirements in laparoscopic cholecystectomy.
OBJECTIVE
Perioperative beta blockers are also being advocated for modulation of acute pain and reduction of intraoperative anesthetic requirements. This study evaluated the effect of perioperative use of esmolol, an ultra short acting beta blocker, on anesthesia and modulation of post operative pain in patients of laproscopic cholecystectomy.


METHODS
Sixty adult ASA I & II grade patients of either sex, scheduled for laparoscopic cholecystectomy under general anesthesia, were enrolled in the study. The patients were randomly allocated to one of the two groups E or C according to computer generated numbers. Group E- Patients who received loading dose of injection esmolol 0.5 mg/kg in 30 ml isotonic saline, before induction of anesthesia, followed by an IV infusion of esmolol 0.05 μg/kg/min till the completion of surgery and Group C- Patients who received 30 ml of isotonic saline as loading dose and continuous infusion of isotonic saline at the same rate as the esmolol group till the completion of surgery.


RESULTS
The baseline MAP at 0 minute was almost similar in both the groups. At 8th minute (time of intubation), MAP increased significantly in group C as compared to group E and remained higher than group E till the end of procedure. Intraoperatively, 16.67% of patients in group C showed somatic signs as compared to none in group E. The difference was statistically significant. 73.33% of patients in group C required additional doses of Inj. Fentanyl as compared to 6.67% in group E.


CONCLUSIONS
We conclude that intravenous esmolol influences the analgesic requirements both intraoperatively as well as postoperatively by modulation of the sympathetic component of the pain i.e. heart rate and blood pressure.
Department of Anaesthesiology, Fortis Hospital, Gurgaon, India.
Ritima
R
Dhir
Department of Dayanand Medical College and Hospital, Ludhiana, India.
Mirley Rupinder
MR
Singh
Department of Dayanand Medical College and Hospital, Ludhiana, India.
Tej Kishan
TK
Kaul
Department of Cincinnati Children's Hospital, Cincinnati, USA.
Anurag
A
Tewari
Department of Anaesthesiology, Fortis Hospital, Gurgaon, India.
Ripul
R
Oberoi
Laparoscopic cholecystectomy; beta blocker; esmolol; intraoperative pain; postoperative pain