Bajwa Sukhminder Jit Singh, Lalitha K, Dhar Purnima, Kumar Vijay
Department of Anaesthesiology and Intensive Care Medicine, Gian Sagar Medical College and Hospital, Banur, Punjab, India.
Indian J Anaesth. 2012 Nov;56(6):535-41. doi: 10.4103/0019-5049.104570.
Beta-blockers have been used for attenuation of stress response, decreasing anaesthetic requirement and augmentation of the effect of opioids during general anaesthesia.
The present study aims to evaluate the influence of esmolol on the requirement of an inhalational agent while monitoring the depth of anaesthesia by entropy and also its effect on immediate postoperative pain score.
Fifty American Society of Anaesthesiologists (ASA) I and II patients, between 25 and 65 years of age who underwent lower abdominal surgeries were randomly allocated to two groups: Group E and Group S of 25 patients each. Group E received esmolol infusion while Group S received the same volume of saline infusion. Demographic data, haemodynamics, amount of isoflurane used, end-tidal isoflurane concentration, postoperative pain score and total dose of morphine consumed in immediate postoperative period of 30 min were analyzed by using appropriate statistical tests. Value of P<0.05 was considered significant and P<0.001 as highly significant.
The two groups were comparable with respect to age, weight, ASA physical status, duration of surgery and amount of isoflurane used during anaesthesia. Assessment of postoperative pain was assessed by Visual Analogue Scale (VAS) which showed significant difference at 30 min. The total dose of morphine consumption was significantly less (P<0.05) in Group E for relief of postoperative pain.
We conclude that in light of depth of anaesthesia monitor esmolol has no effect on requirement of isoflurane, but it decreases the postoperative pain as well as postoperative requirement of morphine without increasing the risk of awareness.
β受体阻滞剂已被用于减轻应激反应、降低麻醉需求以及增强全身麻醉期间阿片类药物的效果。
本研究旨在评估艾司洛尔对吸入性麻醉剂需求的影响，同时通过熵值监测麻醉深度，以及其对术后即刻疼痛评分的影响。
五十例年龄在25至65岁之间、接受下腹部手术的美国麻醉医师协会（ASA）I级和II级患者被随机分为两组：每组25例，E组和S组。E组接受艾司洛尔输注，而S组接受相同体积的生理盐水输注。通过适当的统计检验分析人口统计学数据、血流动力学、异氟烷用量、呼气末异氟烷浓度、术后疼痛评分以及术后30分钟即刻吗啡总消耗量。P<0.05被认为具有统计学意义，P<0.001被认为具有高度统计学意义。
两组在年龄、体重、ASA身体状况、手术持续时间以及麻醉期间异氟烷用量方面具有可比性。通过视觉模拟评分法（VAS）评估术后疼痛，结果显示在30分钟时存在显著差异。E组用于缓解术后疼痛的吗啡总消耗量显著较少（P<0.05）。
我们得出结论，鉴于麻醉深度监测，艾司洛尔对异氟烷需求无影响，但它可减轻术后疼痛以及术后吗啡需求，且不增加知晓风险。
