The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study
Objective: A prospective, randomized and double-blind study was planned to identify the optimum dose of esmolol infusion to suppress the increase in bispectral index values and the movement and hemodynamic responses to tracheal intubation. Materials and methods: One hundred and twenty patients were...
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| Format: | Article |
| Language: | English |
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Elsevier
2014-11-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001413001966 |
| _version_ | 1797991910507282432 |
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| author | Mensure Yılmaz Çakırgöz Aydın Taşdöğen Çimen Olguner Hülya Korkmaz Ertuğrul Öğün Burak Küçükebe Esra Duran |
| author_facet | Mensure Yılmaz Çakırgöz Aydın Taşdöğen Çimen Olguner Hülya Korkmaz Ertuğrul Öğün Burak Küçükebe Esra Duran |
| author_sort | Mensure Yılmaz Çakırgöz |
| collection | DOAJ |
| description | Objective: A prospective, randomized and double-blind study was planned to identify the optimum dose of esmolol infusion to suppress the increase in bispectral index values and the movement and hemodynamic responses to tracheal intubation. Materials and methods: One hundred and twenty patients were randomly allocated to one of three groups in a double-blind fashion. 2.5 mg kg−1 propofol was administered for anesthesia induction. After loss of consciousness, and before administration of 0.6 mg kg−1 rocuronium, a tourniquet was applied to one arm and inflated to 50 mm Hg greater than systolic pressure. The patients were divided into 3 groups; 1 mg kg−1 h−1 esmolol was given as the loading dose and in Group Es50 50 μg kg−1 min−1, in Group Es150 150 μg kg−1 min−1, and in Group Es250 250 μg kg−1 min−1 esmolol infusion was started. Five minutes after the esmolol has been begun, the trachea was intubated; gross movement within the first minute after orotracheal intubation was recorded. Results: Incidence of movement response and the ΔBIS max values were comparable in Group Es250 and Group Es150, but these values were significantly higher in Group Es50 than in the other two groups. In all three groups in the 1st minute after tracheal intubation heart rate and mean arterial pressure were significantly higher compared to values from before intubation (p < 0.05). In the study period there was no significant difference between the groups in terms of heart rate and mean arterial pressure. Conclusion: In clinical practise we believe that after 1 mg kg−1 loading dose, 150 μg kg−1 min−1 iv esmolol dose is sufficient to suppress responses to tracheal intubation without increasing side effects. Resumo: Objetivo: Estudo prospectivo, randômico e duplo-cego planejado para identificar a dose ideal de perfusão de esmolol para suprimir o aumento dos valores do BIS e os movimentos e respostas hemodinâmicas à intubação traqueal. Materiais e métodos: 120 pacientes foram randomicamente alocados um dos três grupos, usando o método duplo-cego. Propofol (2,5 mg kg−1) foi administrado para indução da anestesia. Após a perda da consciência e antes da administração de rocurônio (0,6 mg kg−1), um torniquete foi aplicado a um braço e insuflado a 50 mm Hg acima da pressão sistólica. Os pacientes foram divididos em três grupos; uma dose de 1 mg kg−1 h−1 de esmolol foi administrada como carga e perfusão de 50 μg kg−1 min−1 de esmolol foi iniciada no Grupo ES50, 150 μg kg−1 min−1 no Grupo Es150 e 250 μg kg−1 min−1 no Grupo ES250. Cinco minutos após o início da perfusão, a traqueia foi intubada; o total de movimentos no primeiro minuto após a intubação orotraqueal foi registrado. Resultados: A incidência da resposta de movimentos e os valores máximos de ΔBIS foram comparáveis nos grupos ES250 e Es150, mas esses valores foram significativamente mais elevados no Grupo ES50 que nos outros dois grupos. Nos três grupos, os valores de frequência cardíaca e pressão arterial média foram significativamente maiores no primeiro minuto pós-intubação, comparados aos valores pré-intubação (p < 0,05). Não houve diferença significativa entre os grupos em relação à frequência cardíaca e pressão arterial média durante o período de estudo. Conclusão: Na prática clínica, acreditamos que após uma dose com carga de 1 mg kg−1, uma dose de 150 μg kg−1 min−1 de esmolol IV é suficiente para suprimir a resposta à intubação traqueal sem aumentar os efeitos colaterais. Keywords: Depth of anesthesia, Propofol, Intubation, Bispectral index, Esmolol, Palavras-chave: Profundidade da anestesia, Propofol, Intubação, Índice bispectral, Esmolol |
| first_indexed | 2024-04-11T08:59:47Z |
| format | Article |
| id | doaj.art-ba2a15136876469a949dd2a5648e4634 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-11T08:59:47Z |
| publishDate | 2014-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-ba2a15136876469a949dd2a5648e46342022-12-22T04:32:49ZengElsevierBrazilian Journal of Anesthesiology0104-00142014-11-01646425432The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind studyMensure Yılmaz Çakırgöz0Aydın Taşdöğen1Çimen Olguner2Hülya Korkmaz3Ertuğrul Öğün4Burak Küçükebe5Esra Duran6Department of Anesthesiology and Reanimation, Okmeydani Training and Research Hospital, Istanbul, Turkey; Corresponding author.Department of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, Izmir, TurkeyDepartment of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, Izmir, TurkeyDepartment of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, Izmir, TurkeyDepartment of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, Izmir, TurkeyDepartment of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, Izmir, TurkeyDepartment of Anesthesiology and Reanimation, Dokuz Eylül University, School of Medicine, Izmir, TurkeyObjective: A prospective, randomized and double-blind study was planned to identify the optimum dose of esmolol infusion to suppress the increase in bispectral index values and the movement and hemodynamic responses to tracheal intubation. Materials and methods: One hundred and twenty patients were randomly allocated to one of three groups in a double-blind fashion. 2.5 mg kg−1 propofol was administered for anesthesia induction. After loss of consciousness, and before administration of 0.6 mg kg−1 rocuronium, a tourniquet was applied to one arm and inflated to 50 mm Hg greater than systolic pressure. The patients were divided into 3 groups; 1 mg kg−1 h−1 esmolol was given as the loading dose and in Group Es50 50 μg kg−1 min−1, in Group Es150 150 μg kg−1 min−1, and in Group Es250 250 μg kg−1 min−1 esmolol infusion was started. Five minutes after the esmolol has been begun, the trachea was intubated; gross movement within the first minute after orotracheal intubation was recorded. Results: Incidence of movement response and the ΔBIS max values were comparable in Group Es250 and Group Es150, but these values were significantly higher in Group Es50 than in the other two groups. In all three groups in the 1st minute after tracheal intubation heart rate and mean arterial pressure were significantly higher compared to values from before intubation (p < 0.05). In the study period there was no significant difference between the groups in terms of heart rate and mean arterial pressure. Conclusion: In clinical practise we believe that after 1 mg kg−1 loading dose, 150 μg kg−1 min−1 iv esmolol dose is sufficient to suppress responses to tracheal intubation without increasing side effects. Resumo: Objetivo: Estudo prospectivo, randômico e duplo-cego planejado para identificar a dose ideal de perfusão de esmolol para suprimir o aumento dos valores do BIS e os movimentos e respostas hemodinâmicas à intubação traqueal. Materiais e métodos: 120 pacientes foram randomicamente alocados um dos três grupos, usando o método duplo-cego. Propofol (2,5 mg kg−1) foi administrado para indução da anestesia. Após a perda da consciência e antes da administração de rocurônio (0,6 mg kg−1), um torniquete foi aplicado a um braço e insuflado a 50 mm Hg acima da pressão sistólica. Os pacientes foram divididos em três grupos; uma dose de 1 mg kg−1 h−1 de esmolol foi administrada como carga e perfusão de 50 μg kg−1 min−1 de esmolol foi iniciada no Grupo ES50, 150 μg kg−1 min−1 no Grupo Es150 e 250 μg kg−1 min−1 no Grupo ES250. Cinco minutos após o início da perfusão, a traqueia foi intubada; o total de movimentos no primeiro minuto após a intubação orotraqueal foi registrado. Resultados: A incidência da resposta de movimentos e os valores máximos de ΔBIS foram comparáveis nos grupos ES250 e Es150, mas esses valores foram significativamente mais elevados no Grupo ES50 que nos outros dois grupos. Nos três grupos, os valores de frequência cardíaca e pressão arterial média foram significativamente maiores no primeiro minuto pós-intubação, comparados aos valores pré-intubação (p < 0,05). Não houve diferença significativa entre os grupos em relação à frequência cardíaca e pressão arterial média durante o período de estudo. Conclusão: Na prática clínica, acreditamos que após uma dose com carga de 1 mg kg−1, uma dose de 150 μg kg−1 min−1 de esmolol IV é suficiente para suprimir a resposta à intubação traqueal sem aumentar os efeitos colaterais. Keywords: Depth of anesthesia, Propofol, Intubation, Bispectral index, Esmolol, Palavras-chave: Profundidade da anestesia, Propofol, Intubação, Índice bispectral, Esmololhttp://www.sciencedirect.com/science/article/pii/S0104001413001966 |
| spellingShingle | Mensure Yılmaz Çakırgöz Aydın Taşdöğen Çimen Olguner Hülya Korkmaz Ertuğrul Öğün Burak Küçükebe Esra Duran The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study Brazilian Journal of Anesthesiology |
| title | The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study |
| title_full | The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study |
| title_fullStr | The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study |
| title_full_unstemmed | The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study |
| title_short | The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study |
| title_sort | effect of different doses of esmolol on hemodynamic bispectral index and movement response during orotracheal intubation prospective randomized double blind study |
| url | http://www.sciencedirect.com/science/article/pii/S0104001413001966 |
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