Research Article
BibTex RIS Cite

The Effect of Esmolol Use on Intraoperative Sevoflurane, Fentanyl Use and Perioperative Analgesic Drug Consumption in Patients Undergoing Elective Grade 3-4 Surgery

Year 2022, Volume: 19 Issue: 2, 361 - 369, 28.08.2022
https://doi.org/10.35440/hutfd.1140199

Abstract

References

  • 1- Preiser JC, Ichai C, Orban JC, Groeneveld AB. Metabolic response to the stress of critical illness. Br J Anaesth 2014; 113: 945-54.
  • 2- Gordon EK, Fleisher LA. Reducing perioperative cardiac morbidity and mortality: is this the right goal? Curr Opin Crit Care 2013; 19: 342-5.
  • 3- Ersanlı M. Kalp hastasının kalp dışı cerrahi öncesi değerlendirilmesinde klinik kardiyoloğun yaklaşımı. Türk Kardiyol Der Arş 2001; 29: 117-130.
  • 4- Anderson JL, Antman EM, Harold JG, Jessup M, O'Gara PT, Pinto FJ, et al. Clinical Practice Guidelines on Perioperative Cardiovascular Evaluation: collaborative efforts among the American College of Cardiology, the American Heart Association, and the European Society of Cardiology. Eur Heart J 2014; 35: 2342-3.
  • 5- Coloma M, Chiu JW, White PF. The Use of Esmolol as an Alternative to Remifentanil During Desflurane Anesthesia for Fast-Track Outpatient Gynecologic Laparoscopic Surgery. Anesth Analg 2001; 92: 352-7.
  • 6- Akhtar S, Barash PG. Significance of beta-blockers in the perioperative period. Curr Opin Anaesthesiol 2002; 15: 27-35.
  • 7- Wiest DB, Haney JS. Clinical pharmacokinetics an therapeutic efficacy of esmolol. Clin Pharmacokinet 2012; 51: 347-56.
  • 8- Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999; 100: 1043-9.
  • 9- Mangano DT, Goldman L. Preoperative assessment of patients with known or suspected coronary disease. N Engl J Med 1995; 333: 1750-6.
  • 10- Coleman RM, Tousignant-Laflamme Y, Ouellet P, Parenteau-Goudreault É, Cogan J, Bourgault P. The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: a review of the literature. Pain Res Manag 2015; 20: e33-7.
  • 11- Taş N, Tür A, Kocamanoğlu S. Bispektral İndeks (BIS) ile anestezi derinliği izlemenin volatil ajan tüketimi, derlenme kriterleri ve hastanede kalış süresine etkisi. Türk Anestezi ve Reanimasyon Dergisi 2008; 36: 340-5.
  • 12- Ho JE, Larson MG, Ghorbani A, Cheng S, Coglianese EE, Vasan RS, et al. Long-term cardiovascular risks associated with an elevated heart rate: the Framingham Heart Study. J Am Heart Assoc 2014; 3(3): e000668.
  • 13- Thigpen JC, Odle BL, Harirforoosh S. Opioids: A Review of Pharmacokinetics and Pharmacodynamics in Neonates, Infants, and Children. Eur J Drug Metab Pharmacokinet 2019; 44: 591-609.
  • 14- Lindenauer PK, Pekow P, Wang K, Mamidi DK, Gutierrez B, Benjamin EM. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med 2005; 353: 349-61.
  • 15- Domanski D, Schwarz ER. Clinical Review: Is the perioperative use of beta-blockers still recommended? A critical review of recent controversies. J Cardiovasc Pharmacol Ther 2009; 14: 258-68.
  • 16- Cakırgöz MY, Taşdöğen A, Olguner C, Korkmaz H, Oğün E, Küçükebe B, et al. The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study. Rev Bras Anestesiol 2014; 64: 425-32.
  • 17- Foëx P, Sear JW. Challenges of β-blockade in surgical patients. Anesthesiology 2010; 113: 767-71.
  • 18- Ollila A, Vikatmaa L, Sund R, Pettilä V, Wilkman E. Efficacy and safety of intravenous esmolol for cardiac protection in non-cardiac surgery. A systematic review and meta-analysis. Ann Med 2019; 51: 17-27.
  • 19- Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, Hert SD, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 2014; 35: 2383-431.
  • 20- Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 130: e278-333.
  • 21- Priebe HJ. Perioperative β blocker therapy. IARS Review Course Lectures 2003; 60-6.
  • 22- Chia YY, Chan MH, Ko NH, Liu K. Role of [beta]-Blockade in Anaesthesia and Postoperative Pain Management After Hysterectomy. Br J Anaesth 2004; 93: 799-805
  • 23- White PF, Wang B, Tang J. The Effect of Intraoperative Use of Esmolol and Nicardipine on Recovery After Ambulatory Surgery Anesth Analg 2003; 97: 1633-8.
  • 24- Wilson ES, McKinlay S, Crawford JM, Robb HM. The influence of esmolol non the dose of propofol required for induction of anaesthesia. Anaesthesia 2004; 59: 122-6.
  • 25- Bhawna, Bajwa SJ, Lalitha K, Dhar P, Kumar V. Influence of esmolol on requirement of inhalational agent using entropy and assessment of its effect on immediate postoperative pain score. Indian J Anaesth 2012; 56: 535-41.
  • 26- Berkenstadt H, Loebstein R, Faibishenko I, Halkin H, Keidan I, Perel A. Effect of a single dose of esmolol on the bispectral index scale (BIS) during propofol/fentanyl anaesthesia. Br J Anaesth 2002; 89: 509-11.
  • 27- Ozturk T, Kaya H, Aran G, Aksun M, Savaci S. Postoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomy. Br J Anaesth 2008; 100: 211-4.

Elektif Grade 3-4 Cerrahi Uygulanan Hastalarda Esmolol Kullanımının İntraoperatif Sevofluran, Fentanil Kullanımı ve Perioperatif Analjezik İlaç Tüketimine Etkisi

Year 2022, Volume: 19 Issue: 2, 361 - 369, 28.08.2022
https://doi.org/10.35440/hutfd.1140199

Abstract

Amaç: Beta blokerlerin nonkardiyak cerrahiye giden hastalarda perioperatif kardiyak hasarı önleyebileceği gösterilmiştir. Çalışmamızın amacı; kalp dışı operasyona giden ve kardiyak olay gelişimi açısından orta-yüksek riskli hastalarda perioperatif esmolol infüzyonu kullanımının, perioperatif hemodinamiye, tüketilen inhalasyon ajanı ve narkotik madde miktarına, postoperatif tüketilen analjezik ilaç miktarına ve postoperatif yan etkilere olan etkisini araştırmaktır.

Materyal ve Metod: Ocak 2012 - Temmuz 2012 tarihleri arasında, genel anestezi altında elektif üroloji ve genel cerrahi ameliyatları uygulanan ve perioperatif kardiyak olay gelişimi açısından orta-yüksek risk taşıyan 40 hasta çalışmaya dahil edildi. Esmolol grubuna, esmolol 500 µg/kg/dk 1 dakika süresince intravenöz (i.v.) yüklemesi yapılıp kalp atım hızı <80/dk olacak şekilde esmolol infüzyonu, kontrol grubuna ise aynı süre boyunca % 0,9 NaCl i.v. verildi.

Bulgular: Peroperatif dönemde; esmolol grubunda ilaç yükleme sonrası kalp atım hızı (KAH) ve ortalama arter basıncı (OAB) bazal değere göre anlamlı olarak azalırken, kontrol grubunda anlamlı bir değişiklik oluşmadı. Gruplar arasında sevofluran tüketimi açısından farklılık bulunmadı, ancak esmolol grubunda ek fentanil gereksinim sıklığının anlamlı olarak daha düşük olduğu ve kullanılan fentanil miktarının anlamlı olarak daha az olduğu görüldü. Postoperatif dönemde ise; esmolol grubunda KAH ve OAB değerlerinin tüm zaman noktalarında kontrol grubuna göre anlamlı olarak daha düşük olduğu saptandı. Ancak ağrı, postoperatif morfin tüketimi, bulantı, kusma ve titreme açısından gruplar arasında herhangi bir farklılık tespit edilmedi.

Sonuç: Nonkardiyak cerrahi uygulanan orta-yüksek riskli hastalarda esmolol kullanımının perioperatif ve postoperatif dönemde etkin bir hemodinamik stabilizasyon sağladığını ve perioperatif kullanılan narkotik miktarını azalttığını gösterdik. Ancak, tüketilen inhalasyon ajanı ve postoperatif kullanılan analjezik madde miktarı üzerine anlamlı bir etkisini saptayamadık.

References

  • 1- Preiser JC, Ichai C, Orban JC, Groeneveld AB. Metabolic response to the stress of critical illness. Br J Anaesth 2014; 113: 945-54.
  • 2- Gordon EK, Fleisher LA. Reducing perioperative cardiac morbidity and mortality: is this the right goal? Curr Opin Crit Care 2013; 19: 342-5.
  • 3- Ersanlı M. Kalp hastasının kalp dışı cerrahi öncesi değerlendirilmesinde klinik kardiyoloğun yaklaşımı. Türk Kardiyol Der Arş 2001; 29: 117-130.
  • 4- Anderson JL, Antman EM, Harold JG, Jessup M, O'Gara PT, Pinto FJ, et al. Clinical Practice Guidelines on Perioperative Cardiovascular Evaluation: collaborative efforts among the American College of Cardiology, the American Heart Association, and the European Society of Cardiology. Eur Heart J 2014; 35: 2342-3.
  • 5- Coloma M, Chiu JW, White PF. The Use of Esmolol as an Alternative to Remifentanil During Desflurane Anesthesia for Fast-Track Outpatient Gynecologic Laparoscopic Surgery. Anesth Analg 2001; 92: 352-7.
  • 6- Akhtar S, Barash PG. Significance of beta-blockers in the perioperative period. Curr Opin Anaesthesiol 2002; 15: 27-35.
  • 7- Wiest DB, Haney JS. Clinical pharmacokinetics an therapeutic efficacy of esmolol. Clin Pharmacokinet 2012; 51: 347-56.
  • 8- Lee TH, Marcantonio ER, Mangione CM, Thomas EJ, Polanczyk CA, Cook EF, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999; 100: 1043-9.
  • 9- Mangano DT, Goldman L. Preoperative assessment of patients with known or suspected coronary disease. N Engl J Med 1995; 333: 1750-6.
  • 10- Coleman RM, Tousignant-Laflamme Y, Ouellet P, Parenteau-Goudreault É, Cogan J, Bourgault P. The use of the bispectral index in the detection of pain in mechanically ventilated adults in the intensive care unit: a review of the literature. Pain Res Manag 2015; 20: e33-7.
  • 11- Taş N, Tür A, Kocamanoğlu S. Bispektral İndeks (BIS) ile anestezi derinliği izlemenin volatil ajan tüketimi, derlenme kriterleri ve hastanede kalış süresine etkisi. Türk Anestezi ve Reanimasyon Dergisi 2008; 36: 340-5.
  • 12- Ho JE, Larson MG, Ghorbani A, Cheng S, Coglianese EE, Vasan RS, et al. Long-term cardiovascular risks associated with an elevated heart rate: the Framingham Heart Study. J Am Heart Assoc 2014; 3(3): e000668.
  • 13- Thigpen JC, Odle BL, Harirforoosh S. Opioids: A Review of Pharmacokinetics and Pharmacodynamics in Neonates, Infants, and Children. Eur J Drug Metab Pharmacokinet 2019; 44: 591-609.
  • 14- Lindenauer PK, Pekow P, Wang K, Mamidi DK, Gutierrez B, Benjamin EM. Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med 2005; 353: 349-61.
  • 15- Domanski D, Schwarz ER. Clinical Review: Is the perioperative use of beta-blockers still recommended? A critical review of recent controversies. J Cardiovasc Pharmacol Ther 2009; 14: 258-68.
  • 16- Cakırgöz MY, Taşdöğen A, Olguner C, Korkmaz H, Oğün E, Küçükebe B, et al. The effect of different doses of esmolol on hemodynamic, bispectral index and movement response during orotracheal intubation: prospective, randomized, double-blind study. Rev Bras Anestesiol 2014; 64: 425-32.
  • 17- Foëx P, Sear JW. Challenges of β-blockade in surgical patients. Anesthesiology 2010; 113: 767-71.
  • 18- Ollila A, Vikatmaa L, Sund R, Pettilä V, Wilkman E. Efficacy and safety of intravenous esmolol for cardiac protection in non-cardiac surgery. A systematic review and meta-analysis. Ann Med 2019; 51: 17-27.
  • 19- Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, Hert SD, et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 2014; 35: 2383-431.
  • 20- Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 130: e278-333.
  • 21- Priebe HJ. Perioperative β blocker therapy. IARS Review Course Lectures 2003; 60-6.
  • 22- Chia YY, Chan MH, Ko NH, Liu K. Role of [beta]-Blockade in Anaesthesia and Postoperative Pain Management After Hysterectomy. Br J Anaesth 2004; 93: 799-805
  • 23- White PF, Wang B, Tang J. The Effect of Intraoperative Use of Esmolol and Nicardipine on Recovery After Ambulatory Surgery Anesth Analg 2003; 97: 1633-8.
  • 24- Wilson ES, McKinlay S, Crawford JM, Robb HM. The influence of esmolol non the dose of propofol required for induction of anaesthesia. Anaesthesia 2004; 59: 122-6.
  • 25- Bhawna, Bajwa SJ, Lalitha K, Dhar P, Kumar V. Influence of esmolol on requirement of inhalational agent using entropy and assessment of its effect on immediate postoperative pain score. Indian J Anaesth 2012; 56: 535-41.
  • 26- Berkenstadt H, Loebstein R, Faibishenko I, Halkin H, Keidan I, Perel A. Effect of a single dose of esmolol on the bispectral index scale (BIS) during propofol/fentanyl anaesthesia. Br J Anaesth 2002; 89: 509-11.
  • 27- Ozturk T, Kaya H, Aran G, Aksun M, Savaci S. Postoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomy. Br J Anaesth 2008; 100: 211-4.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Hafize Gülşah Özcan 0000-0003-0766-4072

Tuğba Bingöl Tanrıverdi 0000-0003-1303-9695

Burcu Avcı Özbalık 0000-0002-9245-6085

Melek Güra Çelik 0000-0002-5227-0462

Publication Date August 28, 2022
Submission Date July 5, 2022
Acceptance Date August 5, 2022
Published in Issue Year 2022 Volume: 19 Issue: 2

Cite

Vancouver Özcan HG, Bingöl Tanrıverdi T, Avcı Özbalık B, Güra Çelik M. Elektif Grade 3-4 Cerrahi Uygulanan Hastalarda Esmolol Kullanımının İntraoperatif Sevofluran, Fentanil Kullanımı ve Perioperatif Analjezik İlaç Tüketimine Etkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022;19(2):361-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty