Effect of Esmolol on Perioperative Stress Reaction
- Conditions
- Stress ReactionAirway ObstructionCatecholamine; OverproductionEsmolol
- Interventions
- Drug: saline
- Registration Number
- NCT05694585
- Lead Sponsor
- Xiumei Song
- Brief Summary
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 .
- Detailed Description
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.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 46
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description esmolol group Esmolol esmolol group: esmolol 50 μg/kg /min were 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 solution saline Saline group: saline 50 μg/kg /min were intravenously 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.
- Primary Outcome Measures
Name Time Method Changes in plasma norepinephrine levels up to 30 minutes after beginning of operation level of Norepinephrine
Changes in plasma cortisol levels up to 30 minutes after beginning of operation level of cortisol
Changes in plasma epinephrine levels up to 30 minutes after beginning of operation level of epinephrine
- Secondary Outcome Measures
Name Time Method Hemodynamic changes ：Heart rate（HR） from anesthesia induction to 30 minutes after remove the laryngeal mask Heart rate（HR） during perioperative period
Laryngeal mask airway (LMA) removal time Duration from the end of anesthetics infusion to LMA removal Duration from the end of anesthetics infusion to LMA removal
Hemodynamic changes ：Diastolic blood pressure（ DBP） from anesthesia induction to 30 minutes after remove the laryngeal mask Diastolic blood pressure（ DBP） during perioperative period
Hemodynamic changes ：Systolic blood pressure（SBP ） from anesthesia induction to 30 minutes after remove the laryngeal mask Systolic blood pressure (SBP ) during perioperative period
Incidence of adverse reactions: Severe sinus bradycardia from anesthesia induction to 30 minutes after remove the laryngeal mask Severe sinus bradycardia: HR\<40 times/min during perioperative period
Incidence of adverse reactions: bronchospasm from anesthesia induction to 30 minutes after remove the laryngeal mask Perioperative bronchospasm