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Effects of esmolol on haemodynamic response to CO 2 pneumoperitoneum for laparoscopic surgery
Author(s) -
Koivusalo A.M.,
Scheinin M.,
Tikkanen I.,
YliSuomu T.,
Ristkari S.,
Laakso J.,
Lindgren L.
Publication year - 1998
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1998.tb05159.x
Subject(s) - esmolol , medicine , pneumoperitoneum , anesthesia , isoflurane , mean arterial pressure , saline , hemodynamics , blood pressure , heart rate , surgery , laparoscopy
Background : Carbon dioxide (CO 2 ) pneumoperitoneum for laparoscopic surgery increases arterial pressures, systemic vascular resistance and heart rate and decreases urine output. Methods : In this double‐blind randomized study esmolol, an ultrashort‐acting β1‐adrenoceptor antagonist was compared with physiological saline (control) in 28 patients undergoing laparoscopic surgery in standardized 1 MAC isoflurane anaesthesia. Alfentanil infusion was used to prevent the increase of mean arterial pressure more than 25% from baseline. Results : Esmolol effectively prevented the pressor response to induction and maintenance of CO 2 pneumoperitoneum. Significantly ( P <0.001) less alfentanil was needed in the esmolol group than in the control group. Urine output was higher ( P <0.05) and plasma renin activity ( P <0.01) and urine N‐acetyl‐β‐D‐glucosaminidase levels lower in the esmolol group when compared with the control group. Conclusions : Esmolol blunts the pressor response to induction and maintenance of pneumoperitoneum and may protect against renal ischaemia during pneumoperitoneum.