The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy
BackgroundPerioperative opioid administration results in postoperative nausea and vomiting (PONV) and acute opioid tolerance that manifests in increased postoperative pain. Esmolol is an ultra short acting cardioselective β1-adrenergic receptor antagonist, and it has been successfully used for perio...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2010-09-01
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| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kjae-59-179.pdf |
| _version_ | 1819207693226737664 |
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| author | Sang-Jun Lee Jong-Nam Lee |
| author_facet | Sang-Jun Lee Jong-Nam Lee |
| author_sort | Sang-Jun Lee |
| collection | DOAJ |
| description | BackgroundPerioperative opioid administration results in postoperative nausea and vomiting (PONV) and acute opioid tolerance that manifests in increased postoperative pain. Esmolol is an ultra short acting cardioselective β1-adrenergic receptor antagonist, and it has been successfully used for perioperative sympatholysis and it reduces the opioid requirement during total intravenous anesthesia. We tested the hypothesis that perioperative esmolol administration results in decreased PONV and postoperative pain.MethodsSixty patients undergoing laparoscopic appendectomy were randomly assigned to two groups (Group E and Group C). The Group E patients were administered 5-10 µg/kg/min esmolol with remifentanil that was titrated to the autonomic response. The Group C patients received normal saline that was of the same volume as the esmolol in Group E, and the remifentanil was also titrated to the vital sign. Before intubation and extubation, the Group E patients were administered 1.0 mg/kg esmolol, and the Group C patients were administered normal saline of the same volume. The incidence and severity of PONV, the pain score, the rescue antiemetics and the rescue analgesics were assessed 30 min, 6 h and 24 h after surgery. The mean arterial pressure and heart rate under anesthesia were also recorded.ResultsPONV and postoperative pain were significantly increased in Group C. These patients needed more antiemetics and analgesics in the first 24 postoperative hours. The mean arterial pressure and heart rate were significantly higher in Group C at the time of intubation and extubation.ConclusionsPerioperative esmolol administration contributes to the significant decrease in PONV and postoperative pain, and so this facilitates earlier discharge. |
| first_indexed | 2024-12-23T05:27:33Z |
| format | Article |
| id | doaj.art-eb332f7044b64c0e83d8bb42801ab04f |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-23T05:27:33Z |
| publishDate | 2010-09-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-eb332f7044b64c0e83d8bb42801ab04f2022-12-21T17:58:34ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632010-09-0159317918410.4097/kjae.2010.59.3.1796946The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomySang-Jun Lee0Jong-Nam Lee1Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, Busan, Korea.Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, Busan, Korea.BackgroundPerioperative opioid administration results in postoperative nausea and vomiting (PONV) and acute opioid tolerance that manifests in increased postoperative pain. Esmolol is an ultra short acting cardioselective β1-adrenergic receptor antagonist, and it has been successfully used for perioperative sympatholysis and it reduces the opioid requirement during total intravenous anesthesia. We tested the hypothesis that perioperative esmolol administration results in decreased PONV and postoperative pain.MethodsSixty patients undergoing laparoscopic appendectomy were randomly assigned to two groups (Group E and Group C). The Group E patients were administered 5-10 µg/kg/min esmolol with remifentanil that was titrated to the autonomic response. The Group C patients received normal saline that was of the same volume as the esmolol in Group E, and the remifentanil was also titrated to the vital sign. Before intubation and extubation, the Group E patients were administered 1.0 mg/kg esmolol, and the Group C patients were administered normal saline of the same volume. The incidence and severity of PONV, the pain score, the rescue antiemetics and the rescue analgesics were assessed 30 min, 6 h and 24 h after surgery. The mean arterial pressure and heart rate under anesthesia were also recorded.ResultsPONV and postoperative pain were significantly increased in Group C. These patients needed more antiemetics and analgesics in the first 24 postoperative hours. The mean arterial pressure and heart rate were significantly higher in Group C at the time of intubation and extubation.ConclusionsPerioperative esmolol administration contributes to the significant decrease in PONV and postoperative pain, and so this facilitates earlier discharge.http://ekja.org/upload/pdf/kjae-59-179.pdfesmololponvpostoperative pain |
| spellingShingle | Sang-Jun Lee Jong-Nam Lee The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy Korean Journal of Anesthesiology esmolol ponv postoperative pain |
| title | The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy |
| title_full | The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy |
| title_fullStr | The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy |
| title_full_unstemmed | The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy |
| title_short | The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy |
| title_sort | effect of perioperative esmolol infusion on the postoperative nausea vomiting and pain after laparoscopic appendectomy |
| topic | esmolol ponv postoperative pain |
| url | http://ekja.org/upload/pdf/kjae-59-179.pdf |
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