12563
document
Esmolol blunts the cerebral blood flow velocity increase during emergence from anesthesia in neurosurgical patients . UNLABELLED Cerebral hyperemia has been demonstrated during emergence from anesthesia in neurosurgical patients , but its mechanism is speculative . We performed this study to test the hypothesis that this could be attributed to sympathetic overactivity . Thirty neurosurgical patients were included in a prospective , randomized , double-blinded study comparing esmolol , a short-acting beta-blocker , and a placebo . Esmolol ( 0.3 mg. kg ( -1 ) . min ( -1 ) ) was infused from the end of anesthesia to 15 min after extubation . Cerebral blood flow velocity ( CBFV ) , mean arterial blood pressure , and heart rate were recorded before anesthesia , during anesthesia after surgery , at extubation , and 5-60 min after extubation . Cardiac output ( COe ) was estimated by using an esophageal Doppler from anesthesia to 60 min after extubation . CBFV , COe , and heart rate were significantly lower in the esmolol group . Mean arterial blood pressure was comparable between the groups . There was no correlation between CBFV and COe at any time point during the study . In conclusion , esmolol blunted the CBFV increase during emergence , confirming that sympathetic overactivity contributes to cerebral hyperemia during neurosurgical recovery . IMPLICATIONS Esmolol blunted the postoperative increase in cerebral blood flow velocity in neurosurgical patients . The origin of sympathetic hyperactivity and its potential deleterious consequences require further study .
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Intervention_Pharmacological
Esmolol
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Intervention_Pharmacological
esmolol
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Intervention_Control
placebo .
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Intervention_Pharmacological
Esmolol
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Intervention_Pharmacological
anesthesia
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Intervention_Physical
extubation
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Outcome_Physical
cerebral blood flow velocity increase
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Outcome_Physical
Cerebral hyperemia
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Outcome_Physical
Cerebral blood flow velocity ( CBFV )
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Outcome_Physical
mean arterial blood pressure
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Outcome_Physical
heart rate
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Outcome_Physical
Cardiac output ( COe )
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Outcome_Physical
CBFV
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Outcome_Physical
COe
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Outcome_Physical
heart rate
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Outcome_Physical
Mean arterial blood pressure
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Outcome_Physical
CBFV
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Outcome_Physical
COe
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Outcome_Physical
CBFV increase
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Outcome_Physical
cerebral hyperemia
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Outcome_Physical
cerebral blood flow velocity
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Participant_Condition
neurosurgical patients
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Participant_Condition
neurosurgical patients
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Participant_Sample-size
Thirty
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Participant_Condition
neurosurgical patients
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Participant_Condition
neurosurgical patients