The Inhibitory Effect of Esmolol on Stress Response during Noncardiac Surgery in Aged

Objective To assess the inhibitory effect of esmolol on stress response during noncardiac surgery in aged. Methods 40 patients underwent noncardiac surgery,with aged of 65 years above,were randomized into esmolol group with esmolol intravenous infusion and control group with normal saline intravenous infusion,and 20 cases for each. In esmolol group,0.25mg/kg esmolol was administrated,following a continuous intravenous infusion of 20 to 50 μg/ (kg·min) esmolol was infused until 5 minutes after tracheal extubation. The HR,MBP and RPP were studied at the time points of entering the operating room (T0),before intubation (T1),after intubation immediately (T2),skin incision (T3),at the end of operation (T4),opening eyes on verbal command (T5),and after extubation (T6). And the blood concentration of glucose,BVMA and serum cortisol was analyzed at the time of T0,T2,T3,T4 and T6. Results Compared with control group,the HR,RPP of T2,T5 and T6,the MBP of T2 and T5,and the concentration of glucose of T4 and T6 were decreased obviously in esmolol group (P0.05,or P0.01). The dosage of fentanyl and propofol of esmolol group was (0.4±0.1) mg and (450.8±98.3) mg respectively,and was significantly lower than (0.5±0.1) mg and (580.3±125.7) mg respectively of control group (P0.05). Conclusion Continuous intravenous infusion of esmolol can effectively inhibit the stress responses,as well as decrease the level of blood glucose and the dosage of anesthetics during noncardiac surgery in aged.