Gray R J
Department of Thoracic and Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles.
Chest. 1988 Feb;93(2):398-403. doi: 10.1378/chest.93.2.398.
Esmolol is a new intravenous beta-adrenergic blocker with an ultrashort (nine-minute) elimination half-life, which has been studied predominantly for control of supraventricular tachycardia and management of certain types of hypertension. Clinical studies indicate that the efficacy of esmolol is equivalent to that of propranolol and verapamil for control of supraventricular tachycardia and to sodium nitroferricyanide (sodium nitroprusside) for control of postoperative hypertension. Esmolol also has been shown to control heart rate and blood pressure during episodes of acute myocardial ischemia. Cardioselectivity is similar to that of metoprolol, and the ability to titrate the effect of esmolol may provide additional assurance that beta-adrenergic blockade will remain within the cardioselective range. The most commonly observed adverse effect seen in clinical trials was asymptomatic hypotension. Hypotension may be minimized by titrating to the minimum effective dose and is readily reversed within 10 to 30 minutes of discontinuing the infusion of esmolol. These unique features represent advantages of great potential merit in critical care medicine.
艾司洛尔是一种新型静脉用β肾上腺素能阻滞剂，消除半衰期极短（9分钟），主要用于控制室上性心动过速和治疗某些类型的高血压。临床研究表明，艾司洛尔在控制室上性心动过速方面的疗效与普萘洛尔和维拉帕米相当，在控制术后高血压方面与硝普钠相当。艾司洛尔还被证明可在急性心肌缺血发作期间控制心率和血压。心脏选择性与美托洛尔相似，且能够滴定艾司洛尔的效应可能会进一步确保β肾上腺素能阻滞作用维持在心脏选择性范围内。临床试验中最常见的不良反应是无症状性低血压。通过滴定至最小有效剂量可将低血压降至最低，且在停止输注艾司洛尔后10至30分钟内低血压可迅速逆转。这些独特的特性在危重症医学中具有极大的潜在优势。
