Assessment of the efficacy of esmolol on the haemodynamic changes induced by laryngoscopy and tracheal intubation: a meta-analysis

Acta Anaesthesiologica Scandinavica
E Figueredo, E M Garcia-Fuentes

Abstract

Adrenergic stress response induced by laryngoscopy and tracheal intubation (LTI) appears to be attenuated by esmolol, but its potential clinical benefits have not been fully weighed against possible adverse effects. A systematic search up to May 2000 was performed using MEDLINE, EMBASE, LILACS, Cochrane library, manual searching and bibliographies in all languages. All randomised comparisons of esmolol with placebo on the haemodynamic changes elicited by LTI were obtained. Trials were included in the present meta-analysis if they recorded heart rate (HR), systolic pressure (SBP), mean arterial pressure (MAP) or diastolic pressure (DBP) at three different stages: pre-induction, immediately prior to intubation, and in the post-intubation period. Weighted mean differences (WMD) and 95% confidence intervals (CI) of the changes in the haemodynamic variables between treatment and placebo groups were calculated. Of 72 publications identified, 38 randomised controlled trials containing a total of 2009 patients were finally included. Eleven different regimens and doses of esmolol demonstrated effectiveness in the attenuation of HR and BP after LTI in a dose-dependent manner. The most effective regimen was a loading dose of 500 microg x ...Continue Reading

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Related Concepts

Esmolol hydrochloride
Adrenergic beta-Antagonists
Diastolic Blood Pressure
Dose-Response Relationship, Drug
Pulse Rate
Hemodynamics
Intubation, Intratracheal
Laryngoscopic Surgical Procedures
Propanolamines

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