Evaluation of intravenous esmolol for treatment of postoperative hypertension

The efficacy and safety of intravenous (IV) esmolol to treat postoperative hypertension was studied in 30 adult patients, during emergence and recovery from anesthesia after general surgery. Esmolol was given as an IV infusion when the patient developed systolic blood pressure (SBP) ≥150 mm Hg or diastolic blood pressure (OBP) ≥95 mm Hg and heart rate (HR) ≥70 beats/min in the recovery room. Patients received a dose ranging from 100 to 2,104 mg of esmolol. Mean duration of the infusion was 63.6 ± 28.3 minutes. There were statistically significant differences between the control measurements and the end of esmolol titration for SBP, DBP, and HR. Side effects such as HR less than 60 beats/min or a decrease in SBP greater than 25% were observed in 33% (10/30) of the patient population; however, these effects were temporary and self-limiting. Hypotension (SBP < 90 mm Hg), bronchospasm. or congestive heart failure were not observed in any of the patients. It is concluded that the ultrashort-acting β-adrenergic blocker esmolol was 90% (27/30) efficacious (ie, at least a 10% decrease in SBP or DBP) in controlling postoperative hypertension. As a fastacting, short-lasting antihypertensive drug, it joins the armamentarium of other drugs in the treatment of postoperative hypertension during emergence from anesthesia after general surgery.