The goal of this clinical trial is to observe the effect of low dose continuous infusion of esmolol on perioperative stress response in patients undergoing airway intervention .
Airway intervention is known to activate stress response and release catecholamines resulting in severe hemodynamic instability. Various techniques which are recommended to prevent the stress response include increasing the depth of anesthesia, improving surgical procedures and the use of various pharmacological agents. Esmolol blocks the action of the endogenous catecholamines, we plan low dose esmolol infusion decrease stress response and hemodynamic fluctuation during airway intervention. 46 patients scheduled airway intervention under general anesthesia were randomly divided into esmolol group and control group. esmolol 50μg/kg/min or saline 50μg/kg/min were iv administered before Operation beginning. If HR(heart rate)is greater than 90 beats/min, esmolol or saline 50μg/kg/min is added each time, with interval more than 5 min and the peak value is 200 μg/kg/min. If the heart rate is lower than 60 times/minute, Stop medication. Plasma level of Norepinephrine, epinephrine, and cortisol before induction of anesthesia and 30 minutes after beginning of operation were determined by high-performance liquid chromatography. Perioperative hemodynamics changes, extubation time, incidence of severe sinus bradycardia and bronchospasm were recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
46
Esmolol 50μg/kg /min is intravenously administered before Operation beginning. If HR(heart rate)is greater than 90 beats/min, esmolol 50μg/kg/min is added each time, with interval more than 5 min and the peak value is 200 μg/kg/min. If the heart rate is lower than 60 times/minute, Stop medication.
Saline 50μg/kg /min were iv administered before Operation beginning. If HR(heart rate)is greater than 90 beats/min, saline 50μg/kg/min is added each time, with interval more than 5 min and the peak value is 200 μg/kg/min. If the heart rate is lower than 60 times/minute, Stop medication.
Changes in plasma norepinephrine levels
level of Norepinephrine
Time frame: up to 30 minutes after beginning of operation
Changes in plasma epinephrine levels
level of epinephrine
Time frame: up to 30 minutes after beginning of operation
Changes in plasma cortisol levels
level of cortisol
Time frame: up to 30 minutes after beginning of operation
Hemodynamic changes :Systolic blood pressure(SBP )
Systolic blood pressure (SBP ) during perioperative period
Time frame: from anesthesia induction to 30 minutes after remove the laryngeal mask
Hemodynamic changes :Diastolic blood pressure( DBP)
Diastolic blood pressure( DBP) during perioperative period
Time frame: from anesthesia induction to 30 minutes after remove the laryngeal mask
Hemodynamic changes :Heart rate(HR)
Heart rate(HR) during perioperative period
Time frame: from anesthesia induction to 30 minutes after remove the laryngeal mask
Incidence of adverse reactions: Severe sinus bradycardia
Severe sinus bradycardia: HR\<40 times/min during perioperative period
Time frame: from anesthesia induction to 30 minutes after remove the laryngeal mask
Incidence of adverse reactions: bronchospasm
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Perioperative bronchospasm
Time frame: from anesthesia induction to 30 minutes after remove the laryngeal mask
Laryngeal mask airway (LMA) removal time
Duration from the end of anesthetics infusion to LMA removal
Time frame: Duration from the end of anesthetics infusion to LMA removal