What is the clinical evidence from this study?

Study design: RCT. Population: Orthognathic surgery (n=30). Intervention: Esmolol vs. Sodium nitroprusside (SNP). Primary outcome: Mean blood loss (p=<0.001).

August 1, 1992Anesthesia & Analgesia

Esmolol Is More Effective Than Sodium Nitroprusside in Reducing Blood Loss During Orthognathic Surgery

Q: What are the key findings of this study?

Esmolol reduced mean blood loss compared to sodium nitroprusside (436 vs 895 mL, P<0.001) and provided greater control of blood pressure during orthognathic surgery.

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Key result

Esmolol reduced mean blood loss compared to sodium nitroprusside (436 vs 895 mL, P<0.001) and provided greater control of blood pressure during orthognathic surgery.

Why the study?

Does esmolol reduce blood loss and improve blood pressure control compared to sodium nitroprusside in patients undergoing orthognathic surgery?

Population

30 ASA physical status I and II patients (mean age 22 yr) undergoing LeFort I maxillary osteotomies.

Comparison

Esmolol titrated to target mean arterial blood… vs Sodium nitroprusside continuous infusion at…

Design

RCT, randomly assigned

Follow-up

Intraoperative

Authors

WBWilliam S. BlauUniversity of North Carolina at Chapel Hill EKEnid R. KaferUniversity of North Carolina at Chapel Hill JAJay AndersonSpace Telescope Science Institute

Discussion

Member takes

Implication

Supports preferring esmolol to nitroprusside for controlled hypotension; confirms RCT benefit in orthognathic surgery.

Study Design

Type

RCT (n=30)

Randomization

Randomly assigned

Structured PICO

Does esmolol reduce blood loss and improve blood pressure control compared to sodium nitroprusside in patients undergoing orthognathic surgery?

Population

30 ASA physical status I and II patients (mean age 22 years) undergoing LeFort I maxillary osteotomies.

Intervention

Esmolol (boluses of 500 μg/kg, followed by continuous infusion of 100–300 μg/kg/min) titrated to target mean arterial blood pressure of 55-65 mm Hg.

Comparator

Sodium nitroprusside (SNP) continuous infusion at 0.25-4.00 μg/kg/min titrated to target mean arterial blood pressure of 55-65 mm Hg.

Outcome

Mean arterial blood pressure during the hypotensive period and mean blood loss.surrogate

Main Result

Absolute Event Rate: 436% vs 895%

p-value: p=<0.001

Esmolol provides better blood pressure control and significantly reduces blood loss compared to sodium nitroprusside during orthognathic surgery.

Limitations

Possibility of significant myocardial depression produced by intense β1-adrenergic blockade

Cite This Study

Blau et al. (1992) conducted an RCT in Orthognathic surgery (n=30). Esmolol vs. Sodium nitroprusside (SNP) was evaluated on Mean blood loss (p=<0.001). Esmolol reduced mean blood loss compared to sodium nitroprusside (436 vs 895 mL, P<0.001) and provided greater control of blood pressure during orthognathic surgery.

synapsesocial.com/papers/6a8f2fd477932ea9ca5ebf2e https://doi.org/10.1213/00000539-199208000-00004

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Esmolol Is More Effective Than Sodium Nitroprusside in Reducing Blood Loss During Orthognathic Surgery

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Esmolol Is More Effective Than Sodium Nitroprusside in Reducing Blood Loss During Orthognathic Surgery

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider