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BJA Advance Access published online on November 23, 2007
British Journal of Anaesthesia, doi:10.1093/bja/aem333
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Postoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomy

T. Ozturk1,2,*, H. Kaya1, G. Aran1, M. Aksun1 and S. Savaci1

1 Department of Anaesthesiology and Reanimation, Ataturk Teaching and Research Hospital, Izmir, Turkey
2 Department of Anaesthesiology and Reanimation, Celal Bayar University School of Medicine, 45020 Manisa, Turkey

* Corresponding author: Department of Anaesthesiology and Reanimation, Celal Bayar University School of Medicine, 45020 Manisa, Turkey. E-mail: ozturktulun{at}yahoo.com

Background: In an attempt to decrease haemodynamic instability and early postoperative complications such as nausea, vomiting, and pain, esmolol was added to the routine alfentanil infusion of patients with treated hypertension undergoing laparoscopic cholecystectomy.

Methods: Forty consecutive ASA class II patients with controlled hypertension about to undergo laparoscopic cholecystectomy were randomized into two groups: an esmolol group (Group E, n=20) was given a 1 mg kg–1 bolus of esmolol and a placebo group (Group P, n=20) was given an identical volume of Ringer’s lactate. The rate of esmolol infusion was adjusted to keep the heart rate between 65 and 75 beats min–1 and was 5–10 µg kg–1 min–1 throughout the procedure. After operation, patients reported their nausea using a four-point scale.

Results: Esmolol had an opioid-sparing effect intraoperatively (P=0.001). Postoperative requirements for antiemetics were significantly less in the esmolol group, with no antiemetics given to eight patients. In the placebo group, however, all patients required at least one dose of antiemetic (P=0.007). The frequency of PONV did not correlate to the amounts of alfentanil, propofol, postoperative antiemetics consumed, or to female gender, non-smoking status, and history of PONV or motion sickness. Postoperative analgesic consumption in Group E was significantly lower than in Group P (P=0.012).

Conclusions: Esmolol had an opioid-sparing effect in the intraoperative and immediate postoperative period in hypertensive patients undergoing laparoscopy. When combined with alfentanil, it was more effective than placebo in decreasing early PONV.

Keywords: anaesthesia; general


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