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. 2019 Sep 23;2019(9):CD013435. doi: 10.1002/14651858.CD013435

But 2006.

Methods RCT, parallel design
Participants Total number of randomized participants: 30
Inclusion criteria: people with type II diabetes mellitus undergoing CABG surgery
Exclusion criteria: type I diabetes mellitis; ejection fraction < 40%, liver and kidney insufficiency; bleeding diathesis; valvular heart disease
Type of surgery: CABG
Baseline characteristics
Intervention group (esmolol)
  • Age, mean (SD): 58 (± 6) years

  • Gender, M/F: 8/7

  • History of MI, n: 7

  • History of hypertension, n: 5

  • Ejection fraction, mean (SD), %: 49 (± 5)

  • Preoperative use of beta‐blockers, n: 4


Control group (placebo)
  • Age, mean (SD): 57 (± 5) years

  • Gender, M/F: 6/9

  • History of MI, n: 5

  • History of hypertension, n: 6

  • Ejection fraction, mean (SD), %: 51 (± 5)

  • Preoperative use of beta‐blockers, n: 3


Country: Turkey
Setting: single centre; hospital
Interventions Intervention group (esmolol)
  • Randomized, n = 15; losses = 0; analysed, n = 15 (use of ITT analysis not reported)

  • Details: esmolol 500 µg/kg over 3 min before induction of anaesthesia, followed by infusion 100 µg/kg/min continued until 12 h postoperatively


Control group (placebo)
  • Randomized, n = 15; losses = 0; analysed, n = 15

  • Details: 20 mL normal saline over 5 min, followed by 20 mL/h normal saline

Outcomes Outcomes measured/reported by study authors: amount of glucose‐insulin‐potassium infusion consumption; blood glucose levels; bradycardia (not defined), hypotension (not defined), hypertension; recovery times; length of hospital stay; dysrhythmias; inotropic support
Outcomes relevant to the review: bradycardia; hypotension; length of hospital stay
Notes Funding/declarations of interest: not reported
Study dates: not reported
Note:
  • study included an additional group (magnesium), which we did not include in the review

  • article in Turkish, translated with the help of D Azar (previous review author ‐ Blessberger 2018)

Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not specified
Allocation concealment (selection bias) Unclear risk Not specified
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Although the control group is given normal saline, it is not clear whether this is given as a placebo, and whether anaesthetists are aware of group allocation
Blinding of outcome assessors (detection bias) 
 All outcomes Unclear risk Not specified
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No apparent losses
Selective reporting (reporting bias) Unclear risk Study authors did not report prospective clinical trial registration or publication of a protocol. It was not feasible to effectively assess risk of reporting bias
Other bias Low risk Not detected