Effects of Esmolol on hemodynamics and myocardial injury in patients undergoing laparoscopic radical gastrectomy

Objective To investigate the effects of Esmolol on hemodynamics, myocardial injury and postoperative analgesia in patients undergoing laparoscopic radical gastrectomy. Methods Eighty-four patients with laparoscopic radical gastrectomy in our hospital between September, 2014 and September, 2016 were enrolled into this study and divided into group A (n=42) and group B (n=42) according to random number table. Group A received intravenous injection of Esmolol 0.3 mg/kg 3 min before intubation, intraoperative continuous intravenous infusion of Esmolol until the time to extubation, group B received saline instead of Esmolol. The postoperative intravenous analgesia was performed. The changes of mean arterial pressure (MAP) and heart rate (HR) were observed before anesthesia induction (T0), at the time of injection of Esmolol (or saline) (T1), tracheal intubation (T2), extubation (T3), 10 min after extubation (T4), 20 min after extubation (T5). The levels of lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and serum troponin I (cTnI) were measured before and 5 hours after anesthesia. VAS analgesia scores were compared between the two groups. Results At the time of T1, T2, T3, T4 and T5, there was statistically significant in MAP and HR between the two groups (P<0.05), and there was no significant difference in MAP and HR between T5 and T0 in group A (P>0.05), and there was significant difference in MAP and HR between T5 and T0 in group B (P<0.05); The levels of LDH, CK, CK-MB and cTnI in 5 hours after the operation in the two groups were significantly lower than those before the operation (P<0.05). There was no significant difference in group A at 8 hours after operation as compared the preoperative results (P>0.05), however, there was significant difference in group B (P<0.05). The resting pain and exercise pain VAS score on d1 and d2 in group A were significantly lower than those in group B after the operation (P<0.05), however, there was no statistically significant difference on d3 after the operation (P>0.05). Conclusion For laparoscopic radical gastrectomy patients, Esmolol can make hemodynamic more stable, effectively reduce the degree of myocardial injury, with good postoperative analgesic effect.