Efficiency of Esmolol in Treating Postoperative Arterial Hypertension in Patients with Ischemic Heart Disease

To investigate the efficiency and safety of (β+α)-adrenoblocker esmolol for postoperative arterial hypertention (PAH) in patients with ischemic heart disease. The study included 25 patients (45-65 years, mean age 51.5 ± 7.3) who underwent coronary artery bypass grafting surgery with continuous blood purification (CPB). PAH developed during first post-op hours, all patients were ventilated with 2-4 scale sedation by RASS. All patients had arterial hypertension and were on constant therapy. Esmolol was administered IV push 20 mg within a minute. When required, injection was repeated in 5 min until full required effect. Maximum dose was 100 mg. For intraoperative treatment of hypertension 80 mg bolus within 30 sec was injected followed by 150 mg/kg/min infusion when required. Post-op dosage was administered similarly. Esmolol treatment was efficient in 82.6% of cases. Most frequent target AH was achieved using up to 40 and 60 mg in 20% and 36.9% of cases accordingly. Antihypertension effect maintained within 24 hours after injection. Esmolol cause moderate reduction of heart rate (4-7%), making it possible to use in case of hypertension without tachycardia. It is well tolerated and safe as no side effects were observed. The study showed high efficiency and safety of using esmolol to manage post-op arterial hypertension in cardiac surgery patients.