The Effect Of Esmolol On Sevoflurane Requirement And Postoperative Recovery Quality In Patients Undergoing Endovenous Laser Ablation And Stripping Of Great Saphenous Vein

BackgroudEsmolol is an ultra-short-actingβ₁-adrenergic receptor antagonist.Accumulated evidences showed that esmolol could not only inhibit the stress response to intraoperative nociceptive stimuli,but also effectively decrease anesthetic consumption during propofol anesthesia.The present study aims to investigate the effect of esmolol on sevoflurane requirement and postoperative recovery quality in patients undergoing endovenous laser ablation and stripping of the great saphenous vein.MethodsSixty patients undergoing elective endovenous laser ablation and stripping of the great saphenous vein were randomized into two groups of thirty patients each:Group control and Group esmolol.Patients in Group esmolol received esmolol administration with bolus injection of 0.5 mg·kg^-1 before anesthesia induction and followed by a continuous infusion at a rate of 0.2 mg·kg^-1·min^-1,while patients in Group control received same volume of saline.General anesthesia was induced by propofol(1.5-2.5 mg·kg^-1),sufentanil(0.5μg·kg^-1)and rocuronium(0.6-0.8 mg·kg^-1)and maintained with sevoflurane and remifentanil.The end-tidal concentration of sevoflurane was adjusted to maintain Narcotrend index in stage D0-D2.Demographic data of patients and anesthesia time,operative time,perioperative hemodynamic,end-tidal concentration of sevoflurane,perfusion index,Narcotrend index,postoperative pain statue,onset of postoperative nausea and vomiting and intraoperative awareness were recorded.ResultsThere were no significant differences in mean arterial pressure,heart rate,Narcotrend index and perfusion index between Group esmolol and Group control during anesthesia（P>0.05）.The end-tidal concentrations of sevoflurane before and after laser ablation in Group esmolol were lower than those in Group control（1.26±0.28%,1.26±0.28%and 1.69±0.24%,1.69±0.24%）,respectively（P<0.05）.Administration of esmolol resulted in a 25.4%decrease in mean sevoflurane requirement,and 22.2%and 30.4%decrease in male and female patients,respectively.In Group esmolol,the end-tidal concentrations of sevoflurane before or after laser ablation in male patients were higher than those in female patients（P<0.05）.There was no statistical differencein postoperative pain statue,onset of postoperative nausea and vomiting and incidence of perioperative awareness between groups.ConclusionIntraoperative administration of esmolol could decrease the requirement of sevoflurane in patients undergoing endovenous laser ablation and stripping of great saphenous vein,but it has no effect on postoperative recovery quality.