Esmolol

Esmolol (trade name Brevibloc) is a cardioselective beta1 receptor blocker with rapid onset, a very short duration of action, and no significant intrinsic sympathomimetic or membrane stabilizing activity at therapeutic dosages.

It is a class II antiarrhythmic.

Esmolol decreases the force and rate of heart contractions by blocking beta-adrenergic receptors of the sympathetic nervous system, which are found in the heart and other organs of the body. Esmolol prevents the action of two naturally occurring substances: epinephrine and norepinephrine.

Despite reducing pain after laparoscopic cholecystectomy, esmolol did not prevent Postoperative nausea and vomiting, whether used alone or in combination with ramosetron ¹⁾.

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2: Wahal C, Grant SA, Gadsden J, Rambhia MT, Bullock WM. Femoral artery block (FAB) attenuates thigh tourniquet-induced hypertension: a prospective randomized, double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2021 Mar;46(3):228-232. doi: 10.1136/rapm-2020-102113. Epub 2021 Jan 11. PMID: 33431616.

3: Wang H, Zhang Y, Xin F, Jiang H, Tao D, Jin Y, He Y, Wang Q, Po SS. Calcium- Induced Autonomic Denervation in Patients With Post-Operative Atrial Fibrillation. J Am Coll Cardiol. 2021 Jan 5;77(1):57-67. doi: 10.1016/j.jacc.2020.10.049. PMID: 33413942.

4: Zhang Q, Sun Y, Wang B, Wang S, Mu F, Zhang Y. Comparative study of the Ambu® AuraOnce™ laryngeal mask and endotracheal intubation in anesthesia airway management during neurosurgery. J Int Med Res. 2020 Feb;48(2):300060520902606. doi: 10.1177/0300060520902606. PMID: 32036718; PMCID: PMC7111043.

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13: Srivastava VK, Agrawal S, Gautam SK, Ahmed M, Sharma S, Kumar R. Comparative evaluation of esmolol and dexmedetomidine for attenuation of sympathomimetic response to laryngoscopy and intubation in neurosurgical patients. J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):186-90. doi: 10.4103/0970-9185.155146. PMID: 25948898; PMCID: PMC4411831.

14: Bebawy JF, Houston CC, Kosky JL, Badri AM, Hemmer LB, Moreland NC, Carabini LM, Koht A, Gupta DK. Nicardipine is superior to esmolol for the management of postcraniotomy emergence hypertension: a randomized open-label study. Anesth Analg. 2015 Jan;120(1):186-192. doi: 10.1213/ANE.0000000000000473. PMID: 25296247.

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23: Bilotta F, Lam AM, Doronzio A, Cuzzone V, Delfini R, Rosa G. Esmolol blunts postoperative hemodynamic changes after propofol-remifentanil total intravenous fast-track neuroanesthesia for intracranial surgery. J Clin Anesth. 2008 Sep;20(6):426-30. doi: 10.1016/j.jclinane.2008.04.006. PMID: 18929282.

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29: Grillo P, Bruder N, Auquier P, Pellissier D, Gouin F. Esmolol blunts the cerebral blood flow velocity increase during emergence from anesthesia in neurosurgical patients. Anesth Analg. 2003 Apr;96(4):1145-1149. doi: 10.1213/01.ANE.0000055647.54957.77. PMID: 12651674.

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