BACKGROUND: Lidocaine, alpha, beta-adrenergic blocker, angiotensin converting enzyme inhibitor, and various other analgesics have been used for blocking awakening, movements, and hemodynamic instability during general anesthesia. The purpose of this study was to evaluate the ability of esmolol to attenuate the cardiovascular, motor, and central nervous system responses to nociceptive stimulation, such as intubation, during general anesthesia.

METHODS: Forty randomly selected patients participated in this study either as a control (n = 20) or as a study (n = 20) group, respectively. As soon as patients lost consciousness, at a propofol effect-site concentration of 4 µg /ml, a touniquet was applied to one arm and inflated to 150 mmHg higher than the systolic pressure, and then vecuronium (1 mg/kg) was injected. Simultaneously esmolol (1 mg/kg + 250 µg /kg/min) or normal saline were injected in the study and control groups respectively. Four minutes after starting esmolol, orotracheal intubation was administered. We monitered the BP, HR, BIS and gross movement during the study.

RESULTS: Statistically significant differences were observed in mean BP, HR, and BIS between the two groups during esmolol injection.

CONCLUSIONS: Esmolol can reduce anesthetic requirements during general anesthesia with propofol.