One of the indications of outpatient surgery is chemical peeling of the face. It usually requires deep sedation with analgesia of short duration. For this purpose we tried to use ketamine(1 mg/kg) and midazolam(0.1 mg/kg) but experienced
frequent
hypertension and tachycardia. We tried to use beta blocker, esmolol for the of control blood pressure and heart rate. The patients were divided into two groups. In control group, eighty-five patients were anesthetized with bolus intravenous
injection of
1 mg/kg of ketamine and 0.1 mg/kg of midazolam. In esmolol group, eighty-three patients received a continuous infusion of esmolol(500 mcg/kg/min for initial dose, followed by 200 mcg/kg/min for maintenance) in addition to midazolarm(0.1 mg/kg)
and
ketamine(1 mg/kg). During operation, we observed systolic, diastolic blood pressure and peripheral oxygen saturation(SaO2). All patients were allowed to breathe spontaneously. There was no case of airway obstruction and SaO2 value was over 98% in
most
cases. So we investigated the effects of esmolol on blood pressure, heart rate, emergence sequelae and patient's acceptance in the anesthesia with ketamine and midazolam in the patient of facial chemical peeling.
@ES The results were as follows:
EN 1) No one could recall.
2) There were no differences on the status of mood, emotion and patients' positive acceptance between two groups.
3) Blood pressure and heart rate were increased during anesthesia with midazolam and ketanine. But esmolol attenuate this response, significantly(P<0.05).
We concluded that esmolol added benefits of control of blood pressure and heart rate in the anesthesia of facial chemical peeling. But the control of the high blood pressure is not so easy, so it is needed to find out the optimal dosage of
esmolol
for
complete blocking of the sympathetic response without complications. (Korean J Anesthesiol 1995; 29: 64~69).
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