lidocaine + esmolol

Lidocaine + esmolol is a combination of two small molecule drugs used primarily in perioperative and anesthetic settings. Lidocaine is an amide-type local anesthetic and class Ib antiarrhythmic agent that works by blocking voltage-gated sodium channels, thereby inhibiting nerve impulse transmission and providing local anesthesia as well as antiarrhythmic effects[4]. Esmolol is a cardioselective beta-1 adrenergic receptor blocker (beta-blocker) with rapid onset and short duration, used to control heart rate, blood pressure, and reduce sympathetic responses during surgery[2][6]. When administered together intravenously, this combination has been shown to reduce postoperative agitation in pediatric patients undergoing sevoflurane anesthesia for strabismus surgery. The mechanism involves lidocaine attenuating airway stimulation while esmolol provides hemodynamic stability and suppresses wakefulness through beta-1 blockade[1]. This combination may also decrease the need for additional analgesics postoperatively.