Ozturk T.Kaya H.Aran G.Aksun M.Savaci S.2024-07-222024-07-22200800070912http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/19144Background: In an attempt to decrease haemodynamic instability and early postoperative complications such as nausea, vomiting, and pain, esmolol was added to the routine alfentanil infusion of patients with treated hypertension undergoing laparoscopic cholecystectomy. Methods: Forty consecutive ASA class II patients with controlled hypertension about to undergo laparoscopic cholecystectomy were randomized into two groups: an esmolol group (Group E, n=20) was given a 1 mg kg-1 bolus of esmolol and a placebo group (Group P, n=20) was given an identical volume of Ringer's lactate. The rate of esmolol infusion was adjusted to keep the heart rate between 65 and 75 beats min-1 and was 5-10 μg kg-1 min-1 throughout the procedure. After operation, patients reported their nausea using a four-point scale. Results: Esmolol had an opioid-sparing effect intraoperatively (P=0.001). Postoperative requirements for antiemetics were significantly less in the esmolol group, with no antiemetics given to eight patients. In the placebo group, however, all patients required at least one dose of antiemetic (P=0.007). The frequency of PONV did not correlate to the amounts of alfentanil, propofol, postoperative antiemetics consumed, or to female gender, non-smoking status, and history of PONV or motion sickness. Postoperative analgesic consumption in Group E was significantly lower than in Group P (P=0.012). Conclusions: Esmolol had an opioid-sparing effect in the intraoperative and immediate postoperative period in hypertensive patients undergoing laparoscopy. When combined with alfentanil, it was more effective than placebo in decreasing early PONV. © The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved.EnglishAll Open Access; Bronze Open AccessAdrenergic beta-AntagonistsAdultAgedAlfentanilAnesthetics, IntravenousAntiemeticsCholecystectomy, LaparoscopicDouble-Blind MethodDrug Administration ScheduleFemaleHeart RateHumansHypertensionMaleMiddle AgedPain, PostoperativePostoperative Nausea and VomitingPropanolaminesSeverity of Illness Indexalfentanilantiemetic agentesmololpropofolRinger lactate solutionalfentanilantiemetic agentbeta adrenergic receptor blocking agentesmololintravenous anesthetic agentpropanolamine derivativeadultarticlecholecystectomyclinical articlecontrolled studydrug dose titrationdrug effectdrug efficacydrug infusiondrug usefemalegenderheart ratehumanhypertensionintraoperative periodmalemotion sicknesspatient codingpostoperative nausea and vomitingpostoperative periodpriority journalrandomizationrating scalesmokingagedcholecystectomyclinical trialcontrolled clinical trialdouble blind proceduredrug administrationhospitalizationhypertensionmiddle agedpostoperative nausea and vomitingpostoperative painrandomized controlled trialPostoperative beneficial effects of esmolol in treated hypertensive patients undergoing laparoscopic cholecystectomyArticle10.1093/bja/aem333