esmolol / Generic mfg. - LARVOL DELTA

Esmolol-Associated Acute Drug-Induced Liver Injury: A Rare Cause of Severe Transaminitis (ACG 2026) - "Figure: Negative gallbladder ultrasound. Common bile duct measuring 2 mm"

Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Nephrology • Renal Disease

Visceral Vasculature in Crisis: Hepatic Artery Dissection and Celiac Artery Arteritis Presenting as Hypertensive Emergency (ACG 2026) - "Blood pressure was managed using esmolol infusion followed by oral amlodipine...There is a lack of agreement that celiac artery dissection and dissection of other arteries without rupture or ischemia is an emergency and requires surgical intervention. This case shows that abdominal pain and celiac artery dissection is common and causes a hypertensive crisis."

Cardiovascular • Nephrology • Renal Calculi

Esmolol Versus Standard Care in Patients with Septic Shock and Persistent Tachycardia (ACS-CLINCON 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular • Septic Shock

Beta-Blockers for the Treatment of Arrhythmias: Which Drug for Which Arrhythmia? A State-of-the-Art Narrative Review. (PubMed, Am J Cardiovasc Drugs) - "In adrenergically mediated inherited syndromes, namely catecholaminergic polymorphic ventricular tachycardia and long QT syndrome, nonselective agents and especially nadolol are clearly superior to beta1-selective agents, and the same principle appears to extend to ventricular electrical storm, in which propranolol has outperformed metoprolol in a randomized comparison. In acute care, pharmacokinetics dominate, and the ultra-short-acting agents esmolol and landiolol permit a degree of titration that longer-acting drugs cannot match. In patients with heart failure and reduced ejection fraction, carvedilol, metoprolol succinate, and bisoprolol should be preferred irrespective of arrhythmia subtype because of their established mortality benefit. Conversely, beta1-selective agents, including the highly selective agent nebivolol, improve tolerability in bronchospastic disease, although this reflects respiratory tolerability rather than any demonstrated antiarrhythmic..."

Journal • Review • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Genetic Disorders • Heart Failure • Ventricular Tachycardia

Medical Management of Aortic Emergencies in Critical Care Transport. (PubMed, Prehosp Emerg Care) - "We observed a similar odds of achieving HR and SBP targets regardless of medication used in a large sample of patients with aortic emergencies. While a combination of beta and calcium channel blockers may be optimal medical therapy, treatment with esmolol, labetalol, or nicardipine as single agents may be reasonable to achieve HR and SBP goals."

Journal • Cardiovascular • Critical care • Hypotension

Effect of Electroconvulsive Therapy on Intracranial Pressure: An Evaluation Using Optic Nerve Sheath Diameter Measurements. (PubMed, J ECT) - "These findings strongly suggest that ECT does not induce substantial alterations in intracranial pressure, as determined through ONSD ultrasonography. Nevertheless, it is imperative to underscore the necessity for further research encompassing larger patient cohorts and those who may have baseline elevations of ICP."

Journal • Anesthesia • CNS Disorders • Epilepsy • Mental Retardation • Psychiatry

Ea/Ees and oscillatory power fraction capture complementary but distinct components of ventriculoarterial coupling: a porcine study. (PubMed, Front Physiol) - "In 14 juvenile pigs challenged with vasoactive (phenylephrine, nitroprusside) and cardioactive drugs (dobutamine, esmolol) titrated toward protocolized targets (± 40% MAP, ± 50% dP/dt), we obtained a comprehensive dataset using intracardiac conductance catheters, intraaortic pressure probes, and ascending aortic flow probes. This is consistent with the two indices reflecting predominantly steady and pulsatile aspects of arterial load, although the present data do not demonstrate that separation directly. While OPF cannot replace Ea/Ees, power-derived indices offer practical adjuncts for characterizing ventriculoarterial interactions and the effects of selected drugs at the intensive care bedside."

Journal • Preclinical • Critical care

Accelerometer-based evaluation of left ventricular diastolic function (ESC 2026) - "Measurements were performed at baseline and during different interventions including esmolol infusion, adrenaline infusion and induction of myocardial ischaemia... Accelerometer-derived LV impulse during early filling correlates closely with the invasive gold standard of ventricular diastolic function across different interventions. This technique offers a novel approach for continuous diastolic function monitoring using accelerometers in implantable devices, with potential extension to wearable devices for non-invasive, long-term assessment."

Cardiovascular • Congestive Heart Failure • Heart Failure

Autonomous closed-loop intravenous esmolol for systolic blood pressure regulation and beat-to-beat variability suppression with safety supervision: a large-animal validation study (ESC 2026) - "Conclusions A closed-loop intravenous esmolol system achieved autonomous SBP regulation within a predefined target band while simultaneously reducing beat-to-beat BPV, with preserved secondary haemodynamic stability and reliable automated safety responses in a large-animal model. These findings provide proof-of-concept for device-based autonomous hypertension and BPV control warranting translation to human studies."

Cardiovascular • Hypertension

Intraoperative Hemodynamic Management and Cerebral Protection During Awake Craniotomy: Evidence-Based Approaches. (PubMed, Anesthesiol Res Pract) - "Preventive strategies, such as scalp blocks, individualized blood pressure targets, and the use of dexmedetomidine and midazolam, improved intraoperative stability, while short-acting agents, including esmolol and labetalol, were preferred for rapid control. Looking ahead, advanced monitoring and emerging AI systems may provide new opportunities to enhance cerebral protection and optimize patient safety. This review summarizes evidence on intraoperative hemodynamic control in awake craniotomy, emphasizing strategies that enable maximal safe resection while preserving neurological function."

Journal • Review • Anesthesia • Brain Cancer • Cardiovascular • Glioma • Hypertension • Hypotension • Oncology • Pain • Solid Tumor

Comparison of propofol alone vs propofol-phenylephrine combination for intraoperative hemodynamic stability in glioma surgery. (PubMed, World J Methodol) - "Adding phenylephrine to propofol for induction and maintenance provides superior hemodynamic stability without compromising brain relaxation in glioma surgery."

Journal • Anesthesia • Brain Cancer • Glioma • Hypotension • Oncology • Solid Tumor

Dynamic Hemodynamic Management in Hybrid Repair of Type B Aortic Dissection (ASA 2026) - "She was initially managed in the MICU with nicardipine and esmolol infusions targeting SBP 90-110 mmHg...Intraoperative management was challenged by rapidly shifting hemodynamic goals requiring strict blood pressure control to prevent propagation, augmentation during bilateral carotid manipulation for cerebral perfusion, transient hypotension for graft deployment, and post-deployment hypertension. This case highlights the importance of dynamic, phase-specific management."

Cardiovascular • Hypertension • Hypotension

Anesthetic Management of Refractory Thyrotoxicosis with Limited Medical Options: Preventing ThyroidStorm During Thyroidectomy (ASA 2026) - "40-year-old female with Graves' disease and toxic multinodular goiter presented for thyroidectomyafter failure of first-line therapies (methimazole-induced agranulocytosis, propylthiouracilhypersensitivity), remaining severely thyrotoxic (TSH <0.01, elevated T3/T4) with AF and HFpEF. Total intravenous anesthesia with invasive monitoring and multimodal sympatholysis(esmolol, dexmedetomidine, magnesium) enabled controlled induction and maintenance, preventingcardiovascular collapse or thyroid storm. Postoperative was uneventful."

Agranulocytosis • Cardiovascular • Endocrine Disorders • Granulocytopenia • Grave’s Disease • Immunology

Extreme Hemodynamic Instability During Robotic-to-Open Pheochromocytoma Resection Managed with Advanced Hemodynamic Monitoring (ASA 2026) - "Tumor manipulation resulted in severe hypertensive episodes (SBP >175 mmHg) associated with ST-segment changes, requiring esmolol, nicardipine, and nitroglycerin infusions. Following adrenal vein ligation, profound hypotension and shock developed (SBP <60 mmHg), necessitating norepinephrine, dopamine, hydrocortisone, and aggressive resuscitation...Refractory hyperglycemia required continuous insulin infusion. After eight hours of significant hemodynamic lability, the patient was successfully extubated and transferred to the ICU hemodynamically stable and off vasopressor support."

Metastases • Diabetes • Hypotension • Pancreatic Cancer • Solid Tumor

Anesthetic Management of Newly Diagnosed Cor Triatriatum Sinister in Pregnancy (ASA 2026) - "A pre-induction arterial line was placed, and rapid sequence induction using remifentanil, esmolol, propofol, and succinylcholine was performed to avoid tachycardia and maintain sinus rhythm. Intraoperative transesophageal echocardiography guided fluid management. The patient remained hemodynamically stable, was safely extubated and discharged 4 days later with plans for future surgical repair."

Cardiovascular • Pulmonary Disease • Respiratory Diseases

Challenges of Hemodynamic Optimization in Pediatric Right Heart Failure (ASA 2026) - "Considerations of medical risk and hemodynamic optimization led her to receive isoflurane and vasopressin prior to cardiopulmonary bypass and an esmolol infusion, which converted her arrhythmia. Post-bypass challenges included bleeding and hypothesized pulmonary hyperemia without hemorrhage."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Pediatrics

Successful Intraoperative Hemodynamic Management during Complex Pheochromocytoma Resection (ASA 2026) - "Prepared clevidipine and esmolol infusions were started, requiring brisk uptitration, and significant bolus doses were administered in addition to drips...The post-operative course involved weaning of high dose pressors with successful discharge 6 days later. This case highlights the necessity of thorough preoperative planning to successfully manage instant hemodynamic shifts during pheochromocytoma resection."

Cardiovascular • Hypertension • Hypotension • Solid Tumor • ADRB2

Routine Cataract Surgery Complicated by Intraoperative Reverse Takotsubo Cardiomyopathy Following Sub-Tenon Block (ASA 2026) - "Following fentanyl and midazolam, the surgical team performed a sub-Tenon block with 1 mL of 1% lidocaine and 1.5% phenylephrine. Shortly thereafter, the patient developed acute hypertension, tachycardia, and chest pain requiring nitroglycerin and esmolol boluses...She was admitted for evaluation, and transthoracic echocardiography revealed reverse Takotsubo cardiomyopathy. Systemic phenylephrine absorption was suspected as the precipitating factor causing this rare form of stress-induced heart dysfunction."

Surgery • Cardiomyopathy • Cardiovascular • Cataract • Heart Failure • Hypertension • Ophthalmology

Severe Hypertensive Crisis Following Anticholinergic Reversal of tcMEP-Induced Bradycardia (ASA 2026) - "Rescue anticholinergics promptly resolved bradycardia but precipitated profound hypertensive crisis (BP 239/132), requiring urgent esmolol and nicardipine for stabilization...This biphasic autonomic response suggests tcMEP-induced central vagal activation abruptly reversed by anticholinergic administration, leading to unopposed sympathetic outflow. While tcMEP stimulation has been rarely associated with autonomic disturbances, this extreme presentation is not well described."

Cardiovascular

Recurring Tachycardia in Patient with Friedrich Ataxia (ASA 2026) - "During emergence, patient has episode of tachycardia with HR to 182 with severe hypotension that is initially treated with esmolol and resolves...Over next few hours, patient has multiple episodes of atrial fibrillation with rapid ventricular response and requires 4 vasopressors and multiple defibrillations attempts. Patient was ultimately palliatively extubated."

Clinical • Ataxia • Atrial Fibrillation • Cardiovascular • Hypotension • Movement Disorders

Anesthetic Management for the Resection of a Metabolically Active Bladder Paraganglioma (ASA 2026) - "Preoperatively, he was placed on doxazosin for alpha blockade...This was managed with a multimodal pharmacologic approach, including nicardipine, esmolol, vasopressin, and nitroglycerin. Notably, this case was performed with hemodynamic monitoring via non-invasive continuous arterial monitoring. The patient recovered well and was discharged home on post-operative day one."

Solid Tumor

Calm the Storm: Perioperative Management of a Patient with Thyroid Storm and Acute Coronary Syndrome Undergoing Urgent Coronary Artery Bypass Graft Surgery (ASA 2026) - "Anesthesia induction was notable for severe hypertension (SBP >260 mmHg) and tachycardia, managed with nitroglycerin, nicardipine, and esmolol. Postoperatively, beta-blockade was transitioned to propranolol to reduce peripheral T4-to-T3 conversion while aligning with guideline-directed medical therapy."

Clinical • Surgery • Acute Coronary Syndrome • Cardiovascular • Endocrine Disorders • Hypertension • Pulmonary Disease • Type 2 Diabetes Mellitus

anesthetic management for modified electroconvulsivetherapy in a patient with parkinson's disease and a large abdominal aortic aneurysm (ASA 2026) - "Nicardipine and esmolol were administered before stimulation, and mECT was delivered after confirming a reduction in blood pressure. The patient completed 10 sessions without significant hypertension, aspiration, or aneurysm-related complications, suggesting strict hemodynamic control may allow safe mECT."

Clinical • Cardiovascular • CNS Disorders • Gastrointestinal Disorder • Hypertension • Movement Disorders • Parkinson's Disease

Dual Closed-Loop Esmolol Nitroglycerin Control: An In Silico Evaluation (ASA 2026) - "Abstract is embargoed at this time."

Esmolol in the management of refractory ventricular fibrillation: a systematic review and meta-analysis. (PubMed, Acute Crit Care) - "The sensitivity analysis suggests potential benefits for sustained ROSC and neurological survival, but more data are needed. Further research is needed to clarify its role."

Journal • Retrospective data • Cardiovascular