Key result
Esmolol with general anesthesia triggers severe cardiovascular collapse requiring ~40 minutes of CPR.
Why the study?
Esmolol is commonly used during anesthetic induction due to its short half-life and perceived safety, but cardiovascular collapse associated with its use remains poorly understood.
Case Report (n=1)
Potential esmolol-induced refractory collapse in diabetics warrants induction caution; leaves open identification of at-risk subgroups.
Esmolol chloride was commonly used in anesthetic induction to blunt cardiovascular responses of tracheal intubation. Because of its short half-life, esmolol was considered as a relative safe agent in anesthetic practice. Here, we present a 49-year-old diabetic female patient scheduled for vitrectomy. She suffered from a cardiovascular collapse after general anesthetic induction combined with esmolol. The bradycardia and shock cannot be corrected with repeated doses of adrenergic agents including epinephrine. Cardiopulmonary resuscitation persisted for forty minutes to regain the vital sign. The followed examinations didn't reveal definite pathology such as acute myocardial infarction or anaphylaxis. In this report, we discussed the possible causes of shock and reviewed the esmolol-related cardiovascular collapse and its treatment.
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Yeh et al. (2010) conducted a case report in Cardiovascular collapse (n=1). General anesthetic induction combined with esmolol was evaluated on Cardiovascular collapse. General anesthetic induction combined with esmolol resulted in a severe cardiovascular collapse requiring 40 minutes of cardiopulmonary resuscitation in a 49-year-old diabetic female.
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