The Effects of Intraoperative Esmolol Infusion on the Postoperative Pain and Hemodynamic Stability after Rhinoplasty.

[BACKGROUND] Esmolol an ultrashort acting cardioselective β1-adrenergic receptor antagonist), has been successfully employed for perioperative sympatholysis. In this study, we tested the hypothesis that perioperative esmolol administration resulted in decreased postoperative pain and improves the hemodynamic balance in patients with rhinoplasty.

[METHODS] In this clinical trial study, fifty-six patients (56) undergoing rhinoplasty surgery were randomly distributed into two groups (Group E and Group C). Patients in the Group E were administered 5-10 µg/kg/min of esmolol in combination with propofol and remifentanil titrated to hemodynamic response. Patients in the Group C were administered normal saline, having same volume as the esmolol in addition to propofol and remifentanil. The mean blood pressure, opioid requirement, pain score, and heart rate were evaluated 30 min, 1 h and 3 h, respectively, after surgery.

[RESULTS] Postoperative pain was reduced significantly in the first 3 postoperative hours, and the need to use morphine was decreased in the group receiving esmolol. Group E patients had significantly less variations in blood pressure and heart rate postoperatively.

[CONCLUSIONS] Intraoperative esmolol infusion is a valid method to reduce postoperative pain, it provide lesser need to analgesics and hemodynamic stability in first 3 hours of post rhinoplasty surgery.