Last reviewed 2026-04-22 · How we verify

Prophylactic esmolol

Esmolol is a selective beta-1 adrenergic receptor antagonist that rapidly reduces heart rate and blood pressure to prevent perioperative tachycardia and hypertension.

Esmolol is a selective beta-1 adrenergic receptor antagonist that rapidly reduces heart rate and blood pressure to prevent perioperative tachycardia and hypertension. Used for Prophylaxis of perioperative tachycardia and hypertension during anesthesia and surgery, Acute intraoperative and postoperative tachycardia management.

At a glance

Mechanism of action

Esmolol blocks beta-1 adrenergic receptors on cardiac tissue, decreasing heart contractility and conduction velocity while reducing sympathetic nervous system activity. Its ultra-short half-life (approximately 9 minutes) and rapid onset make it ideal for acute perioperative hemodynamic control. When used prophylactically, it prevents the stress-induced tachycardia and hypertension that occur during anesthesia induction and surgical stimulation.

Approved indications

• Prophylaxis of perioperative tachycardia and hypertension during anesthesia and surgery
• Acute intraoperative and postoperative tachycardia management

Common side effects

• Hypotension
• Bradycardia
• Dizziness
• Nausea
• Fatigue
• Dyspnea

Key clinical trials

• The Effects of Esmolol on the Hemodynamic Response to Orotracheal Extubation (PHASE4)
• Role of Intraoperative Beta Blocker for Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery (PHASE4)

Primary sources

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Competitive intelligence

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