Застосування есмололу для лікування післяопераційної артеріальної гіпертензії у пацієнтів з ішемічною хворобою серця

The objective: to evaluation of the efficacy and safety of β-adrenoblocker esmolol to treat postoperative arterial hypertension (PAH) in patients with ischemic heart disease. Materials and methods. The study included 30 patients (45–78 years, mean age – 60.5 ± 17.3 years) who underwent coronary artery bypass grafting surgery with continuous blood purification. PAH developed during the first post-operative hours, and all patients were ventilated under sedation with a RASS (Richmond Agitation-Sedation Scale) score 2–4. All patients had arterial hypertension and were on constant antihypertensive therapy. Esmolol was administered intravenously as a bolus push 20 mg within a minute. When required, injection was repeated in 5 minutes until full required effect. For intraoperative treatment of hypertension 80 mg bolus within 30 seconds was injected followed by 150 mg/kg/min infusion when required. Post-operative dosage was administered similarly. Results. Esmolol treatment was efficient in 82.6% of cases. Most often, the target level of arterial pressure was achieved at doses of 40 and 60 mg in 20% and 36.7% of cases, respectively. Antihypertensive effect maintained within 24 hours after injection. Esmolol caused moderate reduction of heart rate (by 4–7%), making it possible to use in case of hypertension without tachycardia. The drug was well tolerated and demonstrated a favorable safety profile with no side observed effects. Conclusions. Use of esmolol demonstrated high efficacy and safety in management of post-operative arterial hypertension in cardiac surgery patients.