The prophylactic infusion of β_1-blocker esmolol in elderly patients with high risks for undergoning non-cardiac surgery

Objective To explore the effects of prophylactic infusion of esmolol on hemodynamic paramenters and the periopertive myocardial ischemia. Methods Forty patients with high cardiac risk who were undergoing primary total hip replacement were randomly divided into two groups, the esmolol group (n=20) and the control group (n=20). The two groups were monitored with Holter ECG till 48 hours after operation for detecting cardiac ischemia. Patients in the study group were infused with 80～100 μg/(kg·min) esmolol to titrate the heart rate 80 bpm. All patients received the standard general anesthesia and orotracheal intubation. Results the changes of the heart rate and the MAP were significantly greater in the control group than in the esmolol group; while the patients with reversible cardiac ischemia was significantly fewer in the esmolol group than in the control(1 vs 4, P0.01). Conclusions Esmolol can not only stabilize hemodynamic responses to anesthesia and operation, but also decreases the incidence of cardiac ischemia.