[Bolus administration of esmolol for preventing the haemodynamic response to tracheal intubation: a multicentre...

To explore the dose-response relation and the safety of esmolol administered as a single i.v. bolus prior to the induction of anesthesia for preventing the haemodynamic response to tracheal intubation.

1,830 patients from 20 centres were randomly divided into three groups: E1 group, receiving esmolol at a dose of 1 mg/kg; E2 group, at 2 mg/kg and E0 group, receiving 0.9% NaCl. Heart rate, systolic and diastolic, and mean artery blood pressures (MAP) were measured following the induction and 1 to 10 minutes following the intubation.

The patients in the E0 group had greater HR and MAP values after anesthesia induction and tracheal intubation than the patients in the E1 and E2 groups (P < 0.05-0.01). The E1 group had higher HR than the E2 group (P < 0.05-0.01). The incidence of tachycardia after intubation was higher in the E0 group (63.8%) than in the E1 group (34.7%) and the E2 group (22.6%) (P < 0.01). The proportion of hypotention and bradycardia was higher in the two treatment groups than the E0 group (P < 0.01), but no severe adverse event was observed.

A 1-2 mg/kg bolus of esmolol is effective and safe for preventing the haemodynamic response to tracheal intubation. The clinical and side-effects are all dose-related.