Why the study?
Does esmolol attenuate cardiovascular responses to extubation in ASA physical status I and II patients?
Does esmolol attenuate cardiovascular responses to extubation in ASA physical status I and II patients?
Esmolol at a dose of 1.5 mg/kg effectively attenuates the increases in heart rate and systolic blood pressure associated with extubation without causing significant hypotension.
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1.5 mg/kg esmolol attenuates extubation hemodynamics without hypotension; supports adoption in ASA I-II patients and extends RCT evidence for optimal dosing.
Changes in heart rate and systolic blood pressure were measured during extubation and emergence from anesthesia in 40 ASA physical status I and II patients in a double-blind study to assess the effect of three doses of esmolol (1, 1.5, and 2 mg/kg) given as a bolus 2 min after reversal of neuromuscular blockade. Heart rate (P less than 0.01), systolic blood pressure (P less than 0.02), and rate-pressure product (P less than 0.01) increased significantly during extubation of the control group. All doses of esmolol attenuated the increases in heart rate, but 1 mg/kg was insufficient to control the increase in systolic blood pressure. Doses of 1.5 and 2 mg/kg controlled both systolic blood pressure and heart rate, but the larger dose produced significant decreases in systolic blood pressure.
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Dyson et al. (1990) studied this question.
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