Clinical trial of esmolol-induced controlled hypotension with or without acute normovolemic hemodilution in spinal surgery

Young Jin Lim, C. S. Kim, Jae-Hyon Bahk, B. M. Ham, Sanghwan Do

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23 Citations (Scopus)

Abstract

Background: Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28%). Methods: Thirty patients who were scheduled to receive spinal surgery were randomly divided into two groups: an esmolol-induced CH alone group (esmolol group, n=15) and a CH-ANH combined group (E-ANH group, n=15). Controlled hypotension was induced with esmolol 500 μg/kg, followed by a continuous infusion of 0-300 μg/kg/min to maintain mean arterial pressure at 55-65 mmHg. Results: The mean infusion rate of esmolol in the esmolol-ANH group was 46±6 μg/kg/min (mean±SD), which was significantly lower than the 77±9 μg/kg/min used in the esmolol group (P<0.05). The number of units of homologous blood (packed RBC) transfused perioperatively was 2.2±0.6 units in the esmolol-ANH group, which was significantly less than 4.3±0.4 units used in the esmolol group (P<0.01). While O2 delivery decreased significantly during CH, O2 consumption remained unchanged in both groups. No complications resulted from CH or ANH in any of the groups. Conclusion: Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.

Original languageEnglish
Pages (from-to)74-78
Number of pages5
JournalActa Anaesthesiologica Scandinavica
Volume47
Issue number1
DOIs
StatePublished - 1 Jan 2003

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Controlled Hypotension
Hemodilution
Clinical Trials
esmolol
Hematocrit

Keywords

  • Acute normovolemic hemodilution
  • Blood conservation, controlled hypotension
  • Esmolol
  • Spinal surgery

Cite this

@article{2cad68bc872940a68a01fa61622ec3fd,
title = "Clinical trial of esmolol-induced controlled hypotension with or without acute normovolemic hemodilution in spinal surgery",
abstract = "Background: Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28{\%}). Methods: Thirty patients who were scheduled to receive spinal surgery were randomly divided into two groups: an esmolol-induced CH alone group (esmolol group, n=15) and a CH-ANH combined group (E-ANH group, n=15). Controlled hypotension was induced with esmolol 500 μg/kg, followed by a continuous infusion of 0-300 μg/kg/min to maintain mean arterial pressure at 55-65 mmHg. Results: The mean infusion rate of esmolol in the esmolol-ANH group was 46±6 μg/kg/min (mean±SD), which was significantly lower than the 77±9 μg/kg/min used in the esmolol group (P<0.05). The number of units of homologous blood (packed RBC) transfused perioperatively was 2.2±0.6 units in the esmolol-ANH group, which was significantly less than 4.3±0.4 units used in the esmolol group (P<0.01). While O2 delivery decreased significantly during CH, O2 consumption remained unchanged in both groups. No complications resulted from CH or ANH in any of the groups. Conclusion: Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.",
keywords = "Acute normovolemic hemodilution, Blood conservation, controlled hypotension, Esmolol, Spinal surgery",
author = "Lim, {Young Jin} and Kim, {C. S.} and Jae-Hyon Bahk and Ham, {B. M.} and Sanghwan Do",
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T1 - Clinical trial of esmolol-induced controlled hypotension with or without acute normovolemic hemodilution in spinal surgery

AU - Lim, Young Jin

AU - Kim, C. S.

AU - Bahk, Jae-Hyon

AU - Ham, B. M.

AU - Do, Sanghwan

PY - 2003/1/1

Y1 - 2003/1/1

N2 - Background: Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28%). Methods: Thirty patients who were scheduled to receive spinal surgery were randomly divided into two groups: an esmolol-induced CH alone group (esmolol group, n=15) and a CH-ANH combined group (E-ANH group, n=15). Controlled hypotension was induced with esmolol 500 μg/kg, followed by a continuous infusion of 0-300 μg/kg/min to maintain mean arterial pressure at 55-65 mmHg. Results: The mean infusion rate of esmolol in the esmolol-ANH group was 46±6 μg/kg/min (mean±SD), which was significantly lower than the 77±9 μg/kg/min used in the esmolol group (P<0.05). The number of units of homologous blood (packed RBC) transfused perioperatively was 2.2±0.6 units in the esmolol-ANH group, which was significantly less than 4.3±0.4 units used in the esmolol group (P<0.01). While O2 delivery decreased significantly during CH, O2 consumption remained unchanged in both groups. No complications resulted from CH or ANH in any of the groups. Conclusion: Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.

AB - Background: Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28%). Methods: Thirty patients who were scheduled to receive spinal surgery were randomly divided into two groups: an esmolol-induced CH alone group (esmolol group, n=15) and a CH-ANH combined group (E-ANH group, n=15). Controlled hypotension was induced with esmolol 500 μg/kg, followed by a continuous infusion of 0-300 μg/kg/min to maintain mean arterial pressure at 55-65 mmHg. Results: The mean infusion rate of esmolol in the esmolol-ANH group was 46±6 μg/kg/min (mean±SD), which was significantly lower than the 77±9 μg/kg/min used in the esmolol group (P<0.05). The number of units of homologous blood (packed RBC) transfused perioperatively was 2.2±0.6 units in the esmolol-ANH group, which was significantly less than 4.3±0.4 units used in the esmolol group (P<0.01). While O2 delivery decreased significantly during CH, O2 consumption remained unchanged in both groups. No complications resulted from CH or ANH in any of the groups. Conclusion: Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.

KW - Acute normovolemic hemodilution

KW - Blood conservation, controlled hypotension

KW - Esmolol

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