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Esmolol and intraoperative myocardial ischemia: a double-blind study
S M Neustein1, D S Bronheim, S Lasker
1Department of Anesthesiology, Mount Sinai Medical Center, New York, NY 10029-6574.
Journal of Cardiothoracic and Vascular Anesthesia
|June 1, 1994
Summary
Esmolol did not effectively treat myocardial ischemia in patients undergoing revascularization surgery. The study found no significant difference in ischemia incidence between esmolol and placebo groups.
Area of Science:
- Cardiology
- Anesthesiology
- Pharmacology
Background:
- Myocardial ischemia is a significant concern during revascularization surgery.
- Esmolol, a beta-blocker, is sometimes used to manage cardiac conditions.
Purpose of the Study:
- To evaluate the efficacy of esmolol in preventing or treating myocardial ischemia during elective myocardial revascularization.
- To assess the influence of esmolol on intraoperative hemodynamic parameters.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 40 patients.
- Continuous ECG monitoring (leads II and V5) was performed.
- Patients received either esmolol (1.0 mg/kg bolus + 100 mcg/kg/min infusion) or placebo.
Main Results:
- No significant difference in the incidence of myocardial ischemia between esmolol and placebo groups.
- Heart rate and mean arterial pressure decreased significantly in both groups compared to baseline.
- No significant differences in heart rate, mean arterial pressure, or ischemia development between groups.
Conclusions:
- Esmolol, at the tested dosage, was ineffective in treating pre-existing or new-onset myocardial ischemia in this surgical setting.
- Further research may be needed to explore different dosages or patient populations.