Background and aims: Esmolol is an ultra-short acting intravenous β-blocker having a rapid onset and offset of effect. When used as an adjunct, it has been shown to improve the postoperative recovery by reducing postoperative pain intensity and intraoperative anesthetic and opioid requirements and preventing opioid-induced hyperalgesia. The aim of this study is to evaluate the effect of esmolol on postoperative PCA consumption in patients undergoing lumbar surgery.
Methods: With the approval from our institutional review board, we obtained written informed consent from all participants. Forty patients (aged 18-70 years) scheduled for posterior lumbar fixation surgery were enrolled. Patients in Esmolol group received a 0.5 mg/kg IV loading dose of esmolol before anesthesia, followed by infusion of 10 µg/kg/min throughout the operation. Patients in Saline group were infused with the same volume of normal saline. Anesthesia was induced with propofol, remifentail and rocuronium. Anesthesia was maintained with desflurane and remifentanil. PCA was applied immediately after extubation. PCA was made of fentanyl 1mg mixed in normal saline 100ml and administered in basal rate of 1 ml/hr and bolus dose of 1 ml with lockout interval of 10 min.
Results: The accumulate amount of PCA use were significantly lower at 8 hr (17.98 ml vs 33.02 ml), 24 hr (44.03 ml vs 71.94 ml), 48 hr (70.53ml vs 99.06 ml) after surgery in Esmolol group than those were in Saline group (p value < 0.05).
Conclusions: Intraoperative esmolol infusion reduced postoperative PCA consumption in patients receiving lumbar surgery.

INFLUENCE OF ESMOLOL ON POSTOPERATIVE PAIN IN PAITENTS UNDERGOING LUMBAR SURGERY