Intraoperative Esmolol: Can It Reduce the Need of Postoperative Opioid in Laparoscopic Cholecystectomy Patients?

Abstract

Background: Laparoscopic cholecystectomy may be associated with postoperative pain mandating rescue analgesics; intraoperative β-blocker (Esmolol) might improve analgesia and spare opioids. This study was performed to test this potential beneficial effect of intraoperative Esmolol in patients undergoing general anesthesia for laparoscopic cholecystectomy. \nMaterials and Methods: A total of 100 patients of the American sociological association (ASA) physical status-1 scheduled for laparoscopic cholecystectomy under general anesthesia were included. Patients receiving Esmolol were assessed for its effect on postoperative analgesia concerning those who did not receive Esmolol. Esmolol was administered as a bolus dose (0.5mg/kg) just before induction of anesthesia followed by an infusion rate of 0.05mg/kg/min until the completion of surgery. \nResults: Patients in the Esmolol group and the control group were compared. A significant difference in postoperative visual analog scale (p<0.001), need for opioid analgesics (p<0.001), and the time for rescue analgesia (p<0.001) was observed, with the Esmolol group performing better. We also observed a better hemodynamic profile in patients receiving Esmolol as compared to the control group in the postoperative period. The difference in postoperative complications was not statistically significant (p=0.374). \nConclusion: intraoperative Esmolol significantly reduced the postoperative opioids (analgesia) consumption and improved analgesia. The hemodynamic profile of the patients who received intraoperative Esmolol was significantly better. There was no statistically significant difference between study groups regarding intra- and postoperative complications. No major adverse event is noted with the use of Esmolol.