Esmolol reduces perioperative ischemia in noncardiac surgery: a meta-analysis of randomized controlled studies

Journal of Cardiothoracic and Vascular Anesthesia
Giovanni LandoniAlberto Zangrillo

Abstract

Literature increasingly has suggested how beta-blockers could be associated with reductions of mortality and morbidity in noncardiac surgery. Recently, the POISE trial showed that beta-blockers could be harmful in the perioperative period. The authors performed a meta-analysis to evaluate the clinical effects of esmolol in noncardiac surgery. Meta-analysis. Hospitals. A total of 1765 patients from 32 randomized trials. None. Three investigators independently searched BioMedCentral and PubMed. Inclusion criteria were random allocation to treatment and comparison of esmolol versus placebo, other drugs, or standard of care in noncardiac surgery. Exclusion criteria were duplicate publications, nonhuman experimental studies, and no data on clinical outcomes. The use of esmolol was associated with a significant reduction of myocardial ischemia episodes (5/283 [1.76%] in the esmolol group v 16/265 [6.03%] in the control arm, odds ratio [OR] = 0.16 [0.05-0.54], p = 0.003). The authors did not observe significant differences regarding episodes of arrhythmias (8/236 [3.38%] v 22/309 [7.11%], OR = 0.52 [0.23-1.18], p = 0.12) and in the incidence of myocardial infarction (0/148 [0%] v 1/169 [0.59%], OR = 0.23 [0.01-6.09], p = 0.38). Esmolo...Continue Reading

References

Jul 1, 1992·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·P P SinghN Sonnenklar
Oct 1, 1992·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·K S ChungD G Silverman
Jul 1, 1990·Journal of Clinical Anesthesia·D D KanitzJ P Kampine
Feb 1, 1989·Anesthesia and Analgesia·M I GoldC A Skillman
May 1, 1989·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·J P EbertE L Bradley
Jan 1, 1988·Journal of Clinical Anesthesia·E OrnsteinA E Schwartz
May 1, 1995·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·A P BoezaartA Coetzee
May 1, 1994·British Journal of Anaesthesia·R AlexanderM Hetreed
Aug 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·S SharmaR Kalra
Oct 29, 1997·The Annals of Otology, Rhinology, and Laryngology·A AyusoJ Traserra
May 30, 1998·Acta Anaesthesiologica Scandinavica·A M KoivusaloL Lindgren
Jan 5, 2002·Anesthesia and Analgesia·Ruari OrmeAntony Ugoni
Mar 21, 2002·JAMA : the Journal of the American Medical Association·Andrew D Auerbach, Lee Goldman
Nov 28, 2002·British Journal of Anaesthesia·C MenigauxM Chauvin
Nov 25, 2003·Anesthesia and Analgesia·Paul F WhiteAlexander Sloninsky
Nov 8, 2005·Lancet·Z M ChenCOMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group
Sep 19, 2006·Anaesthesia·B M BiccardP Foëx
Feb 10, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Anthony L Kovac, Amy Masiongale
Mar 20, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Alberto ZangrilloGiovanni Landoni
Apr 29, 2015·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Ippei TakeuchiHiroyuki Kamei

Citations

Aug 22, 2015·Current Medical Research and Opinion·Marc O Maybauer, Dirk M Maybauer
Jul 19, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Fabio GuarracinoFederico Pappalardo
Apr 16, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Solomon Aronson, Joseph Varon
Jun 3, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·E J BakkerDon Poldermans
Jun 3, 2016·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Begoña Quintana-VillamandosMaría Carmen González
Aug 16, 2016·Journal of Anesthesia·George GalyfosGeorgios Geropapas
Dec 31, 2016·Journal of Applied Physiology·Matthew D MullerPatrick M McQuillan
Oct 23, 2019·Journal of Anesthesia·Adriana D OpreaMiklos D Kertai

Related Concepts

Esmolol hydrochloride
Adrenergic beta-Antagonists
Postoperative Complications
Propanolamines
Myocardial Ischemia
Perioperative Care
Adrenergic beta-Antagonists
Clinical Investigators
Clinical Trials
Patient Care

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