Vahabi Sepideh, Rafieian Yaser, Abbas Zadeh Abolfazl
a Department of Anesthesiology , Lorestan University of Medical Sciences , Khorramabad , Iran.
b Lorestan University of Medical Science Khorambad , Iran.
J Invest Surg. 2018 Apr;31(2):82-88. doi: 10.1080/08941939.2016.1278288. Epub 2017 Apr 4.
Esmolol an ultrashort acting cardioselective β1-adrenergic receptor antagonist), has been successfully employed for perioperative sympatholysis. In this study, we tested the hypothesis that perioperative esmolol administration resulted in decreased postoperative pain and improves the hemodynamic balance in patients with rhinoplasty.
In this clinical trial study, fifty-six patients (56) undergoing rhinoplasty surgery were randomly distributed into two groups (Group E and Group C). Patients in the Group E were administered 5-10 µg/kg/min of esmolol in combination with propofol and remifentanil titrated to hemodynamic response. Patients in the Group C were administered normal saline, having same volume as the esmolol in addition to propofol and remifentanil. The mean blood pressure, opioid requirement, pain score, and heart rate were evaluated 30 min, 1 h and 3 h, respectively, after surgery.
Postoperative pain was reduced significantly in the first 3 postoperative hours, and the need to use morphine was decreased in the group receiving esmolol. Group E patients had significantly less variations in blood pressure and heart rate postoperatively.
Intraoperative esmolol infusion is a valid method to reduce postoperative pain, it provide lesser need to analgesics and hemodynamic stability in first 3 hours of post rhinoplasty surgery.
艾司洛尔（一种超短效心脏选择性β1肾上腺素能受体拮抗剂）已成功用于围手术期交感神经阻滞。在本研究中，我们检验了以下假设：围手术期给予艾司洛尔可减轻鼻整形术患者的术后疼痛并改善血流动力学平衡。
在这项临床试验研究中，56例行鼻整形手术的患者被随机分为两组（E组和C组）。E组患者给予5 - 10μg/kg/min的艾司洛尔，联合丙泊酚和瑞芬太尼，并根据血流动力学反应进行滴定。C组患者给予生理盐水，其体积与艾司洛尔相同，此外还给予丙泊酚和瑞芬太尼。分别在术后30分钟、1小时和3小时评估平均血压、阿片类药物需求量、疼痛评分和心率。
术后前3小时，术后疼痛明显减轻，接受艾司洛尔的组使用吗啡的需求减少。E组患者术后血压和心率的变化明显较小。
术中输注艾司洛尔是减轻术后疼痛的有效方法，在鼻整形术后的前3小时，它减少了镇痛药物的需求并提供了血流动力学稳定性。
