The Effect of Intraoperative Esmolol to Improve Postoperative Quality of Recovery and Pain After Ambulatory Surgery
Status:
Completed
Trial end date:
2014-12-01
Target enrollment:
Participant gender:
Summary
Seventy percent of surgeries performed in the United States are done in an outpatient
setting.Pain Control after ambulatory surgery is very challenging because patients do not
have access to fast and potent intravenous medications Pain after ambulatory surgery is
poorly controlled in the United States with up to seventy five percent of patients having
moderate to severe pain after ambulatory procedures. Postoperative pain have been associated
with serious morbidity, including myocardial infarction and pulmonary embolism.
The use of intraoperative opioids can result in an exaggerated response to pain
(hyperalgesia) and contribute to an exacerbation of pain after surgical procedures.Opioids
are commonly given intraoperative, not in response to pain, but in response to hyperdynamic
cardiovascular states. Esmolol is a short acting beta 1 antagonist that can be used to
treat/prevent hyperdynamic states during surgery. More importantly, esmolol has been shown to
have central antihyperalgesic effects that might contribute to a reduction in postoperative
pain. It is therefore conceivable that the use of intraoperative esmolol instead of opioids
to avoid hyperdynamic states during surgery can result in lower postoperative pain. Since
postoperative pain can substantially affect postoperative quality of recovery, it is also
conceivable that the use of intraoperative esmolol might result in an improved postoperative
quality of recovery to surgical patients.
The main objective of the current study is to examine the effect of intraoperative esmolol on
postoperative quality of recovery. A secondary objective is to examine the effect of esmolol
on postoperative pain.
Significance: Postoperative pain after ambulatory surgery has been shown to be poorly managed
in The United States. The goal of this study is to investigate if a change in the
intraoperative pharmacologic management of patients undergoing ambulatory surgery can improve
their postoperative quality of recovery and pain.
The research question is; does the use of intraoperative esmolol improve postoperative
quality of recovery after ambulatory surgery? Does the use of intraoperative esmolol improve
postoperative pain after ambulatory surgery?
The hypotheses of this study is; does the use of intraoperative esmolol improves
postoperative quality of recovery after ambulatory surgery. The use of intraoperative esmolol
reduces postoperative pain after ambulatory surgery.