THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN
Aim of the study: to analyze the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care from the sources of the modern available literature. Materials and methods. Bibliosemantic, comparative and systems analysis. The proposed recommendations are based on data fr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2021-06-01
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| Series: | Клінічна та профілактична медицина |
| Subjects: | |
| Online Access: | https://cp-medical.com/index.php/journal/article/view/166 |
| _version_ | 1797658307193733120 |
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| author | V. I. Cherniy T. V. Chernii N.V. Shestak |
| author_facet | V. I. Cherniy T. V. Chernii N.V. Shestak |
| author_sort | V. I. Cherniy |
| collection | DOAJ |
| description | Aim of the study: to analyze the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care from the sources of the modern available literature.
Materials and methods. Bibliosemantic, comparative and systems analysis. The proposed recommendations are based on data from the analysis of modern literature, the results of randomized studies and meta-analyzes devoted to the study of the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care.
Results and discussion. Esmolol is the only ultrashort-acting selective beta-blocker for parenteral administration, which selectively blocks beta-1-adrenergic receptors mediating the cardiac stimulating effect of catecholamines. To a lesser extent, it affects the β2-adrenergic receptors of the bronchi and smooth muscles. At doses above 300 μg/kg per minute, the β1-selectivity of esmolol decreases, the drug competitively blocks β1- and β2-adrenergic receptors. Esmolol is most indicated in anesthetic practice for limiting the endocrine-metabolic response, reducing the risk of cardiac complications, reducing pain intensity, controlling hemodynamics, including ensuring controlled hypotension. The features of the pharmacokinetics of esmolol make it possible to accurately modulate the degree and duration of the decrease in heart rate and blood pressure, depending on the clinical situation, and make esmolol an "ideal" cardiac drug.
Conclusion. The use of ultrashort-acting beta-blockers increases the efficiency and safety of anesthesia, especially in high-risk patients, and creates the prerequisites for ensuring the best treatment results for patients in various fields of surgery. |
| first_indexed | 2024-03-11T17:57:11Z |
| format | Article |
| id | doaj.art-87a17a5406ae42a0ab0c025949fbe831 |
| institution | Directory Open Access Journal |
| issn | 2616-4868 |
| language | English |
| last_indexed | 2024-03-11T17:57:11Z |
| publishDate | 2021-06-01 |
| publisher | State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department |
| record_format | Article |
| series | Клінічна та профілактична медицина |
| spelling | doaj.art-87a17a5406ae42a0ab0c025949fbe8312023-10-17T12:06:43ZengState Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative DepartmentКлінічна та профілактична медицина2616-48682021-06-012778510.31612/2616-4868.2(16).2021.10166THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIANV. I. Cherniy0T. V. Chernii1N.V. Shestak2State Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative Department, KievState Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative Department, KievState Institution of Science "Research and Practical Center of Preventive and Clinical Medicine" State Administrative Department, KievAim of the study: to analyze the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care from the sources of the modern available literature. Materials and methods. Bibliosemantic, comparative and systems analysis. The proposed recommendations are based on data from the analysis of modern literature, the results of randomized studies and meta-analyzes devoted to the study of the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care. Results and discussion. Esmolol is the only ultrashort-acting selective beta-blocker for parenteral administration, which selectively blocks beta-1-adrenergic receptors mediating the cardiac stimulating effect of catecholamines. To a lesser extent, it affects the β2-adrenergic receptors of the bronchi and smooth muscles. At doses above 300 μg/kg per minute, the β1-selectivity of esmolol decreases, the drug competitively blocks β1- and β2-adrenergic receptors. Esmolol is most indicated in anesthetic practice for limiting the endocrine-metabolic response, reducing the risk of cardiac complications, reducing pain intensity, controlling hemodynamics, including ensuring controlled hypotension. The features of the pharmacokinetics of esmolol make it possible to accurately modulate the degree and duration of the decrease in heart rate and blood pressure, depending on the clinical situation, and make esmolol an "ideal" cardiac drug. Conclusion. The use of ultrashort-acting beta-blockers increases the efficiency and safety of anesthesia, especially in high-risk patients, and creates the prerequisites for ensuring the best treatment results for patients in various fields of surgery.https://cp-medical.com/index.php/journal/article/view/166selective beta-1-blocker esmolol, anesthesiology and intensive care |
| spellingShingle | V. I. Cherniy T. V. Chernii N.V. Shestak THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN Клінічна та профілактична медицина selective beta-1-blocker esmolol, anesthesiology and intensive care |
| title | THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN |
| title_full | THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN |
| title_fullStr | THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN |
| title_full_unstemmed | THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN |
| title_short | THE PRINCIPLES OF USING ESMOLOL IN THE PRACTICE OF AN ANESTHESIOLOGIST AND AN INTENSIVE CARE PHYSICIAN |
| title_sort | principles of using esmolol in the practice of an anesthesiologist and an intensive care physician |
| topic | selective beta-1-blocker esmolol, anesthesiology and intensive care |
| url | https://cp-medical.com/index.php/journal/article/view/166 |
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