esmolol / Generic mfg. - LARVOL DELTA

ESA: Esmolol Versus Sufentanil on the Quality of Post-cholecystectomy Recovery Laparoscopic Anaesthesia With Orotracheal Intubation on an Outpatient Basis (clinicaltrials.gov) - P4 | N=120 | Not yet recruiting | Sponsor: University Hospital, Limoges

Intubation • New P4 trial • Anesthesia

Heart rate control strategies in patients on veno-venous extracorporeal membrane oxygenation support. (PubMed, Int J Artif Organs) - "While HR control therapy was well tolerated and effectively reduced HR, it did not seem to improve oxygenation. Larger prospective studies should be designed to ascertain the role of HR control strategies in VV-ECMO patients with elevated CO experiencing refractory hypoxemia."

Journal • Cardiovascular • Hypotension • Respiratory Diseases

Tailored perioperative care in a young patient with functional paraganglioma after a severe hypertensive crisis (Euroanaesthesia 2025) - "Optimal hemodynamic control was achieved with maximum daily doses of phenoxybenzamine, carvedilol and amlodipine, with alprazolam...Hypertension during tumor manipulation was managed with esmolol, magnesium sulfate, and phentolamine...On postoperative day one, he was successfully weaned off vasopressors and later discharged without complications. This case highlights the challenges of managing functional and unpredictable PGs, where refractory hypertension limits standard pharmacological strategies. Success was achieved through multidisciplinary collaboration, procurement of cardiovascular drugs, and a patient-specific perioperative plan, demonstrating the critical role of anesthesiologists in high-risk cases and resulting in improved patient outcomes."

Clinical • Anesthesia • Cardiovascular • Endocrine Cancer • Hypertension • Hypotension • Neuroendocrine Tumor • Oncology • Solid Tumor

Postoperative pain management with opioid free intravenous pump infusion after sleeve gastrectomy - a case series (Euroanaesthesia 2025) - "Magnesium sulphate (2,5gr), dexamethasone (8mg), dexketoprofen (50mg), fentanyl (100μg) and oxycodone (8mg) were given before skin incision. Propofol and rocuronium were used for induction of anaesthesia and desflurane for maintenance. Intraoperative pain management included lidocaine (1mg/kg IBW/h) and esmolol infusion -according to sympathetic stimulation, along with remifentanil (50μg/ml) in low dose...At the end of operation 1gr of paracetamol and 2mg of oxycodone was given in addition to wound infiltration with levobupivacaine 0.25%.Postextubation an infusion pump of nonopioids was initiated (0,5ml/10kg IBW/h). It was a mixture of dexmedetomidine (100μg), lidocaine (1gr) and ketamine (100mg) in N/S (total volume 100ml) according to Mulier's protocol (Mulimix). Additionally paracetamol (1gr) quid and ondansetron (4mg) bid were prescribed...No side effects were recorded. A larger sample of patients should be recruited to solidify these results."

Clinical • Anesthesia • Gastrointestinal Disorder • Obesity • Pain

Hemodynamic management in abdominal paraganglanglioma surgery (Euroanaesthesia 2025) - "We premedicated with midazolam and fentanyl, placed thoracic epidural catheter and cannulated radial artery for invasive monitoring. Induction with lidocaine, fentanyl, Propofol and rocuronium and intubation with McGrath video laryngoscope for less stimulation, without hemodynamic alterations. Maintenance with sevoflurane and remifentanil. During tumor manipulation, blood pressure and sinus tachycardia increased to 130lpm with the need for continuous perfusion of clevidipine, esmolol and magnesium sulfate...The use of hemodynamic monitoring is very useful in the management of these surgeries. It is essential to choose anesthetic drugs with little sympathetic and histamine-releasing stimulation."

Surgery • Anesthesia • Brain Cancer • Cardiovascular • Endocrine Cancer • Glioma • Hypertension • Hypotension • Neuroendocrine Tumor • Oncology • Solid Tumor

The effect of intranasal dexmedetomidine on surgical field quality and hemodynamic stability in transnasal transsphenoidal pituitary surgery (Euroanaesthesia 2025) - "Secondary endpoints included the need for esmolol infusion to manage hypertension, tachycardia, or poor surgical field quality...Future studies comparing dexmedetomidine alone to adrenaline could provide further insight into its potential benefits. We also propose studying patients with acromegaly or Cushing's disease separately as the degree of bleeding may be exaggerated in these cases."

Surgery • Acromegaly • Anesthesia • Cardiovascular • Cushing’s Disease • Endocrine Disorders • Hypertension • Oncology

Intraoperative continuous esmolol infusion for perioperative opioid and postoperative pain reduction: a systematic review of randomized controlled trials, meta-analysis and meta-regression (Euroanaesthesia 2025) - "Primary outcomes were postoperative opioid consumption(POC), pain scores, and intraoperative morphine equivalent(ME) requirements. Pain scores were also lower in the ICEI group (MD = -1.43; 95% CI -2.09 to -0.76; I² = 98.7%; p < 0.001). Meta-regression indicated a significant association between younger age and reduced POC (p < 0.0438) and between higher surgical complexity and intraoperative analgesic use (p < 0.0001).Conclusion(s): Esmolol reduces opioid consumption and pain scores when comparated with placebo."

Retrospective data • Review • Pain

Challenging the Paradigm: IV Amiodarone in Thyroid Storm Without Worsening Thyrotoxicosis (ENDO 2025) - "He was started on IV esmolol and digoxin. Due to persistent tachycardia and hypotension precluding diltiazem use, an IV amiodarone drip was started as per cardiology recommendation...Hydrocortisone was tapered with the continual improvement of FT4, and methimazole was continued for new-onset hyperthyroidism, with outpatient follow-up planned for further workup.Conclusion This case highlights the potential use of IV amiodarone in thyroid storm for refractory arrhythmia despite maximal conventional management without worsening of thyrotoxicosis, as the patient's thyrotoxic symptoms and thyroid function improved despite IV amiodarone. IV amiodarone inhibits peripheral T4 to T3 conversion which in combination with anti-thyroid medications, preferably started before amiodarone to suppress new hormone synthesis, may help control thyrotoxicosis symptoms in the short term. However, data remain limited due to the absence of randomized controlled trials and their known..."

Ataxia • Atrial Fibrillation • Cardiovascular • Endocrine Disorders • Friedreich ataxia • Gastroenterology • Hepatology • Hypotension • Movement Disorders • Pulmonary Embolism • Respiratory Diseases • Septic Shock

Comparison of Landiolol and Esmolol on Haemodynamic Responses During Weaning of Intensive Care Unit Patients with Reduced Ejection Fraction after Vascular Surgery. (PubMed, Card Fail Rev) - "Landiolol produced a more rapid and potent reduction in heart rate than esmolol. A significant reduction in MAP was only seen in the esmolol group."

Journal • Cardiovascular • Congestive Heart Failure • Critical care • Heart Failure

Expression of Concern for The Effect of Dexmedetomidine and Esmolol on Early Postoperative Cognitive Dysfunction After Middle Ear Surgery Under Hypotensive Technique: A Comparative, Randomized, Double-blind Study [Anesth Pain Med. 2021;11(1): e107659]. (PubMed, Anesth Pain Med) - No abstract available

Clinical • Cognitive Disorders • Otorhinolaryngology • Pain

First Results of Our Local Practice Guide Used During the Late Phase of Resuscitation in Patients with Refractory VF in Out of Hospital Cardiac Arrest. (PubMed, Open Access Emerg Med) - "This local practice HEMS treatment algorithm consisted of, among others, cessation of epinephrine and alternating administration of esmolol and norepinephrine combined with enoximone. In patients with persisting VF despite prolonged advanced life support care, a multifaceted bundle of care approach shows promising results and warrants further research. Alternative drug administrations were found to be substantially easier to achieve compared to alternative defibrillation positions."

Journal • Cardiovascular

Esmolol improves sepsis outcomes through cardiovascular and immune modulation. (PubMed, Front Pharmacol) - P2 | "Future multicenter trials are needed to confirm these findings and refine the use of β1AR in sepsis management. Clinical Trial Registration: clinicaltrials.gov, identifier NCT06390748."

Journal • Cardiovascular • Immune Modulation • Immunology • Infectious Disease • Septic Shock • CD4 • CD8 • IL6

Management Challenges in Severe Serotonin Syndrome: A Case Report and Literature Review (APA 2025) - "Her husband reported that she had taken approximately 70 Wellbutrin XL 150mg following...When attempting to taper off sedation, Dexmedetomidine, due to its prolonged use for over 24 hours,it caused withdrawal symptoms, resulting in severe agitation and vital signs instability...We selected Guanfacine over Clonidine which was an effective option as well; but could lead to hypotension (reported rates as high as 44%)...High-dose Benzodiazepines were then initiated as the mainstay of treatment with Lorazepam dose 2mg IV QID. In addition, Gabapentin was added for potentially offering presynaptic inhibitory effects on Glutamatergic neurons...Hydralazine should have been avoided due to its significant inhibitory effects on MAO which could exacerbate serotonin toxicity. Instead, the patient would benefit of rapidly-acting medications with short half-lives, such as Esmolol, particularly to mitigate the risk of hypotension."

Case report • Clinical • Review • Addiction (Opioid and Alcohol) • Anesthesia • Cardiovascular • CNS Disorders • Depression • Epilepsy • General Anxiety Disorder • Hypotension • Major Depressive Disorder • Mood Disorders • Psychiatry

Type-B Aortic Dissection: When Conservative Treatment Falls Short (ATS 2025) - "She was managed conservatively with intravenous nicardipine drip, avoiding esmolol due to bradycardia... Despite initial stabilization and appropriate conservative management, this patient developed rapid complications, including pseudoaneurysms and hematomas, likely leading to fatal rupture. This case underscores the potential for swift deterioration in Type-B aortic dissections, even under optimal medical management. Continuous monitoring and timely consideration of surgical options are essential when conservative treatment is insufficient."

Cardiovascular • Chronic Obstructive Pulmonary Disease • Hypertension • Immunology • Pain • Pulmonary Disease • Respiratory Diseases

Think Twice Before You Have Energy Drink: A Case of Mitral Chordal Rupture in HOCM (ATS 2025) - "The EMS was concerned for possible anaphylaxis, and she was given epinephrine and started on the drip...The patient was switched to phenylephrine drip, started on esmolol drip after amiodarone...These patients should never be treated by septal reduction alone. Surgical MV repair or replacement, with septal myectomy, is the preferred approach."

Clinical • Heart Failure • Obstructive Hypertrophic Cardiomyopathy • Respiratory Diseases

Experimental comparison of esmolol- and blood-based cardioplegia for long aortic clamping times. (PubMed, Thorac Cardiovasc Surg) - "In rat hearts, ECCP offers better hemodynamic recovery and protects the myocardium from ischemia/reperfusion-related damage better than Cala blood cardioplegia even with aortic clamping times of 12."

Journal • Cardiovascular • Reperfusion Injury

Case Report: Refractory Ventricular Fibrillation Resolved by Double External Defibrillation and Beta Blockade. (PubMed, Clin Pract Cases Emerg Med) - "This case continues the trend of several case reports since 2015 that have featured beta blockade and double external defibrillation as a viable solution to refractory ventricular fibrillation. Since there is limited quantifiable data on the efficacy of this treatment, future studies should aim to evaluate whether the combination of DED and beta blockade has the potential to become the new standard in treating RVF over a broader patient population."

Journal • Cardiovascular

Development of a remote assessment technique to measure the interstitial fluid pressure for fluid status monitoring in heart failure (HEART FAILURE 2025) - "After 3 weeks under general anaesthetic, animals received 12-16 mg/kg/hour of esmolol (i.v.) and 0.9% NaCl (10% body weight, i.v.) until a CVP of >10mmHg was maintained...We have developed a minimally invasive technique for continuous measurement of IFP and demonstrated a relationship between IFP and cardiac filling pressure in HF. The IFP assessment may provide a direct measure of fluid status and an indirect measure of haemodynamics facilitating early treatment optimisation."

Cardiovascular • Congestive Heart Failure • Heart Failure

Conservative Management of Acute Myocarditis and Thrombotic Microangiopathy after Elevidys (Delandistrogene Moxeparvovec) (ASGCT 2025) - "Case: He remained ambulatory with current DMD medications of deflazacort 36 mg daily and givinostat (held 2 weeks prior to GT)...Baseline cardiac medications were enalapril, eplerenone, and carvedilol...The day prior, he started 60 mg daily of prednisone for immunosuppression per the label...The next day (Day-4), he reported palpitations while telemetry showed atrial fibrillation, which resolved after 20 minutes of esmolol infusion...Complement blockade with eculizumab was considered for rAAV-associated TMA, but our multispecialty gene therapy team consisting of neurology, cardiology, hematology, and nephrology recommended a conservative watchful waiting approaching... TMA is a poorly understood rAAV toxicity. Complement activation is hypothesized to be a central component of its pathophysiology. However, the scope of rAAV drugs that incite TMA as well as its optimal management remains to be defined."

Late-breaking abstract • Atrial Fibrillation • Cardiovascular • Fibrosis • Gene Therapies • Heart Failure • Hematological Disorders • Hypertension • Inflammation • Muscular Dystrophy • Myositis • Nephrology • Renal Disease • Thrombocytopenia • CST3

Effect of Opioid-free Anaesthesia on Postoperative Delirium in Elderly Patients Undergoing Gastrointestinal Surgery (clinicaltrials.gov) - P4 | N=406 | Not yet recruiting | Sponsor: Qianfoshan Hospital

New P4 trial • Anesthesia • CNS Disorders • Geriatric Disorders

SPINAL ANESTHESIA FOR AUTONOMIC DYSREFLEXIA PREVENTION: A CASE REPORT IN A QUADRIPLEGIC PATIENT (ASRA-SPRING 2025) - "During a previous urologic procedure, the patient had refused SA due to anxiety and experienced severe AD intraoperatively that required treatment with atropine, esmolol, hydralazine, nitroglycerine and a nicardipine infusion...Using a 25 gauge Whitacre spinal needle, 2mL of 0.75% hyperbaric bupivacaine and 0.2mg of morphine were injected intrathecally...However, it has been noted that titrating epidural anesthesia to appropriate dermatomal levels in this patient population is difficult, and there is the possibility of an incomplete sympathectomy.3 Anticoagulation status and infection risk should also be considered when administering neuraxial anesthesia. While treating quadriplegic patients undergoing procedural intervention below the level of their SCI, it may be beneficial to consider SA instead of, or in conjunction with, GA to prevent AD and decrease the associated life-threatening risks."

Case report • Clinical • Anesthesia • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Coronary Artery Disease • Hematological Disorders • Infectious Disease • Myocardial Ischemia • Orthopedics • Pain • Psychiatry • Urology

Landiolol (Rapiblyk) for short-term rate control in supraventricular tachycardia. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Atrial Fibrillation • Cardiovascular • Ventricular Tachycardia

Comparison of Esmolol and Nicardipine treatment in hypertensive acute ıschemic stroke patients. (PubMed, Sci Rep) - "Nicardipine is more effective than Esmolol in blood pressure control in AIS patients who are candidates for invasive procedures such as thrombolysis and thrombectomy. The fact that there is no difference in mortality and morbidity between the two drugs suggests that Esmolol can also be used in selected patients."

Clinical • Journal • Retrospective data • Cardiovascular • Cerebral Hemorrhage • Hypertension • Ischemic stroke

Clevidipine Induced Intrapulmonary Shunting in a Patient with Acute Type B Aortic Dissection. (PubMed, Eur J Case Rep Intern Med) - "Clevidipine may be used as an adjunct to beta blockers if the patient is still hypertensive or beta blockers are contraindicated.Intrapulmonary shunting leading to hypoxia is a rare complication of clevidipine therapy and should be suspected in an otherwise hypoxic patient in whom all other diagnoses have been ruled out."

Journal • Cardiovascular • CNS Disorders • Depression • Hypertension • Pain • Psychiatry

Hypertension in aortic coarctation. (PubMed, Front Cardiovasc Med) - "Early after correction, intravenous antihypertensive agents, such as sodium nitroprusside, esmolol, and labetalol, are commonly used to stabilize blood pressure and reduce the risk of complications like cerebral hemorrhage. Oral beta-blockers, ACE inhibitors (ACE-Is), angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) are most commonly used for chronic hypertension. In this review, we discussed about diagnostic workup and therapeutical strategies for hypertension in AoC patients."

Journal • Review • Cardiovascular • Cerebral Hemorrhage • Heart Failure • Hematological Disorders • Hypertension