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A randomised study of perioperative esmolol infusion for haemodynamic stability during major vascular surgery;
E J Bakker1, N J Ravensbergen, M T Voute
1Department of Anesthesiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Summary
This trial investigates esmolol infusion for heart rate control in vascular surgery patients on beta-blockers. It aims to improve haemodynamic stability and reduce cardiac events during the perioperative period.
Area of Science:
- Cardiology
- Anesthesiology
- Vascular Surgery
Background:
- Perioperative haemodynamic instability is a significant risk in major vascular surgery.
- Chronic beta-blocker therapy is common but may require adjustments during surgery.
Purpose of the Study:
- To evaluate esmolol infusion as an adjunct to chronic beta-blocker therapy for perioperative haemodynamic stability.
- To assess the efficacy of esmolol in maintaining a target heart rate range during major vascular surgery.
Main Methods:
- A double-blind, placebo-controlled, randomized trial involving 260 vascular surgery patients.
- Esmolol titration to maintain heart rate between 60-80 bpm for 24 hours post-anesthesia induction.
- Continuous ECG monitoring for 72 hours to assess heart rate and ischaemia; primary outcome is time outside target heart rate.
Main Results:
- The study will provide data on the efficacy of esmolol titration for heart rate control.
- It will also assess the reduction of cardiac ischaemia and related events.
- Safety parameters including stroke and hypotension will be evaluated.
Conclusions:
- Esmolol titration may offer benefits for heart rate control in vascular surgery patients already on beta-blockers.
- The study aims to provide crucial data on the efficacy and safety of this perioperative strategy.
