Clinical applications of esmolol during noncardiac surgery

To be considered a clinical advance, a drug should have improved pharmacokinetics and dy- namics, should have an easier or more effective means of administration, and should be safer to use. The introduction of the ultrashort-acting, cardioselective β-blocker, esmolol, to the perioperative setting, has provided such an advance for the clinician by allowing greater control of adrenergic breakthrough (hypertension and tachycardia) that may result in myocardial ischemia in the patient with a compromised myocardial oxygen balance.