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September 1, 1998Anesthesia & Analgesia

Esmolol Potentiates Reduction of Minimum Alveolar Isoflurane Concentration by Alfentanil

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Why the study?

Does esmolol reduce the minimum alveolar concentration of isoflurane required during anesthesia with or without alfentanil in adult patients?

Population

100 consenting adult patients

Comparison

Esmolol added to isoflurane with or without… vs Isoflurane alone, or isoflurane with alfentanil

Design

RCT, randomly divided into five treatment groups

Authors

JJJay W. JohansenEmory UniversityGSGerhard SchneiderTechnical University of MunichAWAlastair WindsorEmory University

Discussion

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Implication

Esmolol may reduce isoflurane needs with alfentanil; extends evidence for beta-blocker-opioid-volatile synergies on MAC.

Structured PICO

Does esmolol reduce the minimum alveolar concentration of isoflurane required during anesthesia with or without alfentanil in adult patients?

P
Population
100 consenting adult patients
I
Intervention
Esmolol (continuous large-dose 250 µg/kg/min or small-dose 50 µg/kg/min) added to isoflurane with or without alfentanil (effect site target of 50 ng/mL)
C
Comparator
Isoflurane alone, or isoflurane with alfentanil
O
Outcome
Minimum alveolar anesthetic concentration (MAC) of isoflurane required to prevent movement to skin incision in 50% patientssurrogate

Large-dose esmolol potentiates the anesthetic-sparing effect of alfentanil on isoflurane requirements, demonstrating a synergistic interaction between beta-blockers, opioids, and volatile anesthetics.

Cite This Study

Johansen et al. (1998) studied this question.

synapsesocial.com/papers/6a9114042239ecaee3361416https://doi.org/10.1213/00000539-199809000-00034
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reduction of the MAC of Desflurane with Fentanyl1992 · 130 citations
  2. 2Esmolol and the Adrenergic Response to Perioperative Stimuli1986 · 32 citations
  3. 3The Enflurane-Sparing Effect of Alfentanil in Dogs1987 · 61 citations
  4. 4Some effects of propranolol on the central nervous system1965 · 159 citations
  5. 5Decreased Fentanyl and Alfentanil Dose Requirements with Age. A Simultaneous Pharmacokinetic and Pharmacodynamic Evaluation1987 · 424 citations