Impact of Administration of Esmolol on Nociception Level-guided Control of Nociception.

Launched by CIUSSS DE L'EST DE L'ÎLE DE MONTRÉAL · Feb 26, 2024

Keywords

ClinConnect Summary

This clinical trial is studying the effects of a medication called esmolol on managing pain during and after certain types of surgery. Specifically, the goal is to see how esmolol can help control pain levels in patients undergoing laparoscopic surgeries, such as hysterectomies or left hemicolectomies, while they are under general anesthesia. Researchers want to find out if using esmolol can reduce the amount of another pain medication called remifentanil that patients need during surgery and help improve their comfort after the procedure.

To participate in this trial, you need to be between 18 and 65 years old and in generally good health, as indicated by a score from the American Society of Anesthesiologists. You should not have any allergies to the medications used in the study or certain heart and lung conditions that could make esmolol unsafe for you. If you join the study, you will receive the medication during your surgery and be monitored closely to see how it affects your pain management. If at any point you decide to withdraw from the study, you will no longer be part of it.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Fully consented, American Society of Anesthesiologists Classification Score 1-3 patients from 18yo to 65yo
• • Undergoing laparoscopic surgery associated with sub umbilical mini-laparotomy. Eligible surgeries will be hysterectomy (excluding vaginal approach) and left hemicolectomy, of duration time expected under 180 minutes, under general anesthesia
• • No allergy to one of the medications used in this study
• Exclusion Criteria:
• Contraindication to the use of the study drug (esmolol) is an exclusion criterion :
• • Hypotension
• • Sinus bradycardia
• • Sick sinus syndrome
• • Second and third degree A-V block
• • Pulmonary hypertension
• • Right ventricular failure secondary to pulmonary hypertension
• • Decompensated heart failure
• • Cardiogenic shock
• • Nontreated pheochromocytoma
• • Known hypersensitivity to esmolol or any of the inactive ingredients of the product
• • Allergy to esmolol or other beta blockers (cross-sensitivity is possible)
• • Renal dysfunction
• • Airway disease such as asthma or chronic obstructive pulmonary disease
• • Thyrotoxicosis
• • Myasthenia gravis
• • Raynaud's disease or peripheral circulatory disorder
• Other situations leading to exclusion :
• • Severe mental impairment
• • Chronic use of opioids, β-adrenergic receptors antagonists
• • High risk of conversion to laparotomy according to the surgical team (\>25%)
• • Patients will automatically be excluded after recruitment if they withdraw their consent, or if laparoscopy is converted to laparotomy.