BREVIBLOC SUMMARY
BREVIBLOC (Esmolol Hydrochloride) is a beta1-selective (cardioselective) adrenergic receptor blocking agent with a very short duration of action (elimination half-life is approximately 9 minutes). Esmolol Hydrochloride is:
BREVIBLOC (Esmolol Hydrochloride) is indicated for the rapid control of ventricular rate in patients with atrial fibrillation or atrial flutter in perioperative, postoperative, or other emergent circumstances where short term control of ventricular rate with a short-acting agent is desirable. BREVIBLOC is also indicated in noncompensatory sinus tachycardia where, in the physician's judgment, the rapid heart rate requires specific intervention. BREVIBLOC is not intended for use in chronic settings where transfer to another agent is anticipated.
BREVIBLOC (Esmolol Hydrochloride) is indicated for the treatment of tachycardia and hypertension that occur during induction and tracheal intubation, during surgery, on emergence from anesthesia, and in the postoperative period, when in the physician's judgment such specific intervention is considered indicated.
Use of BREVIBLOC to prevent such events is not recommended.
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NEWS HIGHLIGHTS
Published Studies Related to Brevibloc (Esmolol)
Esmolol Reduces Perioperative Ischemia in Noncardiac Surgery: A Meta-analysis of Randomized Controlled Studies. [2009.10.01]
OBJECTIVE: Literature increasingly has suggested how beta-blockers could be associated with reductions of mortality and morbidity in noncardiac surgery. Recently, the POISE trial showed that beta-blockers could be harmful in the perioperative period. The authors performed a meta-analysis to evaluate the clinical effects of esmolol in noncardiac surgery... CONCLUSIONS: Esmolol seemed to reduce the incidence of myocardial ischemia in noncardiac surgery without increasing the episodes of hypotension and bradycardia. Large randomized trials are necessary to confirm these promising results.
Esmolol reduces perioperative ischemia in cardiac surgery: a meta-analysis of randomized controlled studies. [2009.10]
OBJECTIVE: beta-Blockers were associated with a reduction of mortality and morbidity in noncardiac surgery until recently when the POISE trial showed that beta-blockers could be harmful in the perioperative period because of hypotension and bradycardia. Esmolol is an ultra-short-acting beta-blocker mostly used in emergency and high-risk patients. The authors performed a meta-analysis to evaluate the clinical effects of esmolol in cardiac surgery... CONCLUSIONS: Esmolol reduces the incidence of myocardial ischemia and arrhythmias in cardiac surgery. An increase in bradycardia was noted as well.
A single dose of esmolol blunts the increase in bispectral index to tracheal intubation during sevoflurane but not desflurane anesthesia. [2009.07]
Activation of the peripheral nerve system by endotracheal intubation is accompanied by an increase in bispectral index (BIS).
The effect of esmolol on the QTc interval during induction of anaesthesia in patients with coronary artery disease. [2009.03]
The aim of this study was to evaluate whether esmolol has an effect on QT interval during induction of anaesthesia using etomidate and fentanyl in patients with known coronary artery disease. Sixty patients were prospectively randomised to either a control group or the esmolol group.An infusion of Esmolol attenuated the QTc interval prolongation associated with tracheal intubation.
Beta-1 selective adrenergic antagonist landiolol and esmolol can be safely used in patients with airway hyperreactivity. [2009.01]
This study was undertaken to clarify the effects of esmolol and landiolol, beta-1 selective adrenergic antagonists, on hyperreactive airways in both ovalbumin-sensitized guinea pigs and asthmatic patients. In the animal study, asthma was induced by ovalbumin... The ultra-short-acting beta-1 selective adrenergic antagonists esmolol and landiolol can be safely used perioperatively in patients with airway hyperreactivity.
Clinical Trials Related to Brevibloc (Esmolol)
A Comparison of the Effects of Intraoperative Adminstration of Metoprolol or Esmolol on General Anesthetic Requirement [Recruiting]
We will compare three study groups receiving metoprolol, esmolol, or placebo. Level of
anesthesia will be titrated to achieve the same range of BIS value in all groups. Our
hypothesis is that the metoprolol and esmolol groups will require a lower level of
anesthetic agent to achieve the targeted BIS range, compared to the placebo group.
Our objective is to clarify if metoprolol, in a dose range used for perioperative cardiac
protection, decreases anesthetic requirement.
Esmolol in Cardiac Surgery [Recruiting]
This large randomized double-blind clinical trial (esmolol vs placebo) will enroll patients
undergoing cardiac surgery to study the additive cardiac protection of this therapeutic
strategy.
Manipulation of Arterial Pressure in Acute Ischemic Stroke [Recruiting]
Influence of Esmolol on a Closed-Loop Anesthesia System [Recruiting]
Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage [Completed]
The purpose of the study is to determine whether lowering high blood pressure levels after
the start of a stroke caused by bleeding in the brain (intracerebral haemorrhage) will reduce
the chances of a person dying or surviving with a long term disability. The study will be
undertaken in two phases: a vanguard phase in 400 patients, to plan for a main phase in 2000
patients.
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