Application of nitroglycerin and esmolol during general anesthesia of noncardiac surgery in elderly patients with coronary atherosclerotic heart disease

Zhang Kexin; Ren Facheng

doi:10.3760/cma.j.issn.1673-4777.2018.01.005

Abstract：Objective To investigate the application value of nitroglycerin and esmolol during general anesthesia of noncardiac surgery in elderly patients with coronary atherosclerotic heart disease (CHD).Methods Totally 80 elderly patients with CHD undergoing noncardiac surgery from June 2016 to June 2017 in Beijing Anzhen Hospital,Capital Medical University were randomly divided into observation group and control group,with 40 cases in each group.The control group had no special drug treatment before induction of general anesthesia;the observation group had intravenous administration of nitroglycerin and esmolol before anesthesia induction.Changes of heart rate (HR) and mean arterial pressure (MAP) during perioperative period and occurrence of adverse reactions were analyzed.Results HR and MAP after anesthesia induction,at the time of endotracheal intubation,skin incision and the end of operation were significantly lower than those before anesthesia induction in observation group [(83 ± 11),(84 ± 8),(91 ± 8),(82 ± 8) times/min vs (105 ± 16) times/min;(90 ± 8),(93 ± 7),(99 ± 8),(88 ± 8) mmHg vs(107 ± 12) mmHg] (P ＜0.05);HR and MAP after anesthesia induction,at the time of endotracheal intubation,skin incision and the end of operation in observation group were significantly lower than those in control group[(96 ± 10),(95 ± 11),(96 ± 11),(98 ± 18) times/min;(100 ± 11),(103 ± 14),(106 ± 13),(103 ± 12) mmHg] (P ＜ 0.05).There was no significant difference of incidence of adverse reactions between groups (P ＞ 0.05).Conclusion Nitroglycerin and esmolol can effectively stabilize changes of HR and MAP during noncardiac and reduce cardiac damage in elderly patients with CHD.