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Esmolol as a Perioperative Opioid-Sparing Adjunct: Review of the Literature

Esmolol is an ultra-short-acting, selective β1-receptor antagonist with rapid onset (within 2–3 minutes) and easy titratability.1 It is widely used in the perioperative setting in controlling the ventricular rate in supraventricular tachyarrhythmias and in the management of heart rate and hypertension that may occur during laryngoscopy, surgical stimulation, emergence, and extubation.2 Blunting the adrenergic response to stimuli is particularly useful in patients with ischemic heart disease, where the effects of tachycardia and hypertension can be detrimental.3 Esmolol is rapidly metabolized by esterases present in the cytosol of red blood cells and has a short postinfusion elimination half-life of 9 minutes.1,4 Potential Esmolol as a Perioperative Opioid-Sparing Adjunct: Review of the Literature