The effects of esmolol, esmolol and nicardipine or remifentanil on mean blood pressure, heart rate and recovery in gynecologic laparoscopic surgery

Lee, Ho Young; Kwon, Woo Jin; Lee, Jung Un

Abstract

BACKGROUND: The purpose of this study was to compare the effects of esmolol, esmolol and nicardipine or remifentanil on MBP, HR and recovery in gynecologic laparoscopic surgery.
METHODS
Eighty patients scheduled for gynecologic laparoscopic surgery were randomly allocated to four groups: group C (control group, n = 20); group E (esmolol group, n = 20) received esmolol 1 mg/kg, followed by 5microgram/kg/min; group EN (esmolol + nicardipine group, n = 20) received esmolol 1 mg/kg and nicardipine 15microgram/kg, followed by an esmolol infusion 5microgram/kg/min; and group R (remifentanil group, n = 20) received remifentanil 1microgram/kg, followed by 0.05microgram/kg/min. The MBP and HR were measured at preinduction, after induction, at 1, 3, 5 min after intubation, before and after insufflation of CO2 and during surgical procedures. Recovery profiles and postoperative side effects were assessed.
RESULTS
The change of MBP after intubation was significantly decreased in group EN. The change of HR after intubation and during surgical procedure were significantly decreased in group E and group R. Recovery profiles were significantly faster in all study groups compared with group C.
CONCLUSIONS
The use of esmolol in combination with nicardipine was effective in preventing the increase of MBP after intubation, whereas esmolol or remifentanil had attenuated the acute change of HR to noxious stimuli. Also the use of esmolol, nicardipine or remifentanil as an adjuvant to sevoflurane-N2O anesthesia in gynecologic laparoscopic surgery had facilitated the recovery.