The Protective Effect Of Esmolol On The Myocardium Of Patients With Severe Burn For Surgical Excision Cutting

Object:To explore the protective effect of esmolol on myocardium in severely burned patients with excision.Methods:Selected 60 patients with severe burns for surgical excision cutting who were admitted to hospital from January 2017 to January 2018 as subjects?this study has been approved by the hospital's ethics committee and signed informed consents with patients and their families?and was randomly divided into 2 groups.The esmolol group?E group?and saline control group?N group??n=30?.In group E,the micro-pump was continuously infused with esmolol 50 ug/?kg·min?from 5 minutes before induction of anesthesia to tracheal extubation,and in group N,the same amount of saline was continuously pumped in the same manner until the trachea was extubated..We record and compare heart rate?HR?and mean arterial pressure?MAP?of two groups at 5 minutes before the induction of anesthesia?T₀?,the instant time after the tracheal intubation?T₁?,during the excision?T₂?,in the end of the surgery?T₃?,the instant time after the extubation?T₄?and 15minutes after the extubation?T₅?;Venous blood samples were extracted at 5 min before anesthesia induction,6 hours postoperative and 24 hours postoperative to determine concentrations of the serum cardiac troponin I?cTnI?and myocardium creatine kinase isoenzyme?CK-MB?.Results:HR and MAP in the two groups were significantly different at T₁,T₂,and T₄ time points?P<0.05?.At 6h and 24h after operation,the concentrations of cTnI and CK-MB in group E were significantly lower than those in group N?P<0.05?.Conclusion:Intraoperative continuous pumping of small doses of esmolol can maintain hemodynamic stability and reduce myocardial oxygen consumption,while it can reduce serum cTnI and CK-MB concentrations and myocardial damage,protect the myocardium and be safely used for patients of severe burns and surgical excision cutting.