Experience on esmolol improving brain beat during microvascular decompression surgery for hemifacial spasm

Abstract

Objective To compare the efficacies of esmolol and urapidial in improving brain beat during microvascular decompression surgery for hemifacial spasm.Methods A total of 226patients scheduled for microvascular decompression surgery received general anesthesia with controlled blood pressure,with the mean arterial blood pressure(MAP)being 55-65 mmHg(1mmHg=0.133kPa)and the bispectral index being 40-60.Thirty-two of the 226patients who developed brain beat were randomly assigned to 3groups:group A(esmolol,n=11),B(urapidial,n=11)and C(isotonic NaCl,n=10), receiving intravenous injection of esmolol 10mg,urapidial 5mg and isotonic NaCl 2mL,respectively.The heart rate(HR), mean arterial pressure(MAP)and cardiac output(CO)at T0(before injection),T1(1min after injection),T2(5min after injection),T3(10min after injection),T4(30min after injection),operating time under microscope,and improvement of brain beat were observed.Results There were no significant differences in HR,MAP or CO at T0time between the three groups.HR and CO were significantly decreased in group A compared with those in group C at all time points(P0.01);MAP values were similar between group A and group C.HR,MAP and CO were similar at different time points in group C.The improvement rate of group A was significantly higher than those of group B and group C(P0.01).The operating time under microscope in group A was(18±4) min,which was significantly shorter than those in group B([28±6]min)and group C([29±5]min).Conclusion Esmolol can notably improve the brain beat during microvascular decompression surgery for hemifacial spasm.