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Efficacy of a single dose of esmolol to prevent extubation-related complications during emergence from anesthesia: a randomized, double-blind, placebo-controlled trial.
Mendon A, Fabr Ício Tavares; Barreto Filho, Jorge Humberto; Hungria, Matheus de Bastos Cerqueira Soares; Magalh Es, Thiago Cavalcante.
Afiliação
  • Mendon A FÍT; Hospital de Base do Distrito Federal, Centro de Ensino e Treinamento em Anestesiologia (CET), Bras.ília, DF, Brasil; Sociedade Brasileira de Anestesiologia, T.ítulo Superior em Anestesiologia (TSA), Rio de Janeiro, RJ, Brasil; Universidade de Bras.ília, Mestrado em Ci.»ncias M..dicas, Bras.ília, DF,
  • Barreto Filho JH; Hospital de Base do Distrito Federal, Centro de Ensino e Treinamento em Anestesiologia (CET), Bras.ília, DF, Brasil.
  • Hungria MBCS; Hospital de Base do Distrito Federal, Centro de Ensino e Treinamento em Anestesiologia (CET), Bras.ília, DF, Brasil.
  • Magalh Es TC; Hospital de Base do Distrito Federal, Centro de Ensino e Treinamento em Anestesiologia (CET), Bras.ília, DF, Brasil.
Braz J Anesthesiol ; 73(4): 426-433, 2023.
Article em En | MEDLINE | ID: mdl-34560115
BACKGROUND: Few trials have examined the efficacy of esmolol to attenuate hemodynamic and respiratory responses during extubation. However, the most appropriate dose of esmolol and an optimal protocol for administering this beta-blocker are uncertain. METHODS: Ninety patients ASA physical status I, II, and III (aged 18...60 years) scheduled to procedures with general anesthesia and tracheal extubation were selected. Patients were randomized into esmolol and placebo group to evaluate the efficacy and safety of a single bolus dose of esmolol (2...mg.kg-1) on cardiorespiratory responses during the peri-extubation period. The primary outcome was the rate of tachycardia during extubation. RESULTS: The rate of tachycardia was significantly lower in esmolol-treated patients compared to placebo-treated patients (2.2% vs. 48.9%, relative risk (RR): 0.04, 95% confidence interval (95% CI)...=...0.01 to 0.32, p...=...0.002). The rate of hypertension was also significantly lower in the esmolol group (4.4% vs. 31.1%, RR: 0.14, 95% CI 0.03 to 0.6, p...=...0.004). Esmolol-treated patients were associated with higher extubation quality compared to patients who received placebo (p...<...0.001), with an approximately two-fold increase in the rate of patients without cough (91.1%) in the esmolol group compared to the placebo group (46.7%). The rate of bucking was approximately 5-fold lower in the esmolol group (8.9% vs. 44.5%, respectively, RR: 0.20 (95% CI, 0.1 to 0.5, p...=...0.002, with an NNT of 2.8). CONCLUSION: A single bolus dose of esmolol is an effective and safe therapeutic strategy to attenuate cardiorespiratory responses during the peri-extubation period.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Propanolaminas / Hipertensão Tipo de estudo: Clinical_trials / Etiology_studies / Guideline Limite: Humans Idioma: En Revista: Braz J Anesthesiol Ano de publicação: 2023 Tipo de documento: Article País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Propanolaminas / Hipertensão Tipo de estudo: Clinical_trials / Etiology_studies / Guideline Limite: Humans Idioma: En Revista: Braz J Anesthesiol Ano de publicação: 2023 Tipo de documento: Article País de publicação: Brasil