This study aims to evaluate esmolol's perfusion impact during induction and maintenance of general anesthesia, using Nociception-Level-guided control of nociception, in adult patients undergoing laparoscopic and lower abdominal surgery, on intraoperative remifentanil consumption and postoperative pain in the Post-Anesthesia Care Unit.
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Eligibility Criteria
Inclusion Criteria:
* Fully consented, American Society of Anesthesiologists Classification Score 1-3 patients from 18yo to 65yo
* Undergoing laparoscopic surgery associated with sub umbilical mini-laparotomy. Eligible surgeries will be hysterectomy (excluding vaginal approach) and left hemicolecto…
Inclusion Criteria:
* Fully consented, American Society of Anesthesiologists Classification Score 1-3 patients from 18yo to 65yo
* Undergoing laparoscopic surgery associated with sub umbilical mini-laparotomy. Eligible surgeries will be hysterectomy (excluding vaginal approach) and left hemicolectomy, of duration time expected under 180 minutes, under general anesthesia
* No allergy to one of the medications used in this study
Exclusion Criteria:
Contraindication to the use of the study drug (esmolol) is an exclusion criterion :
* Hypotension
* Sinus bradycardia
* Sick sinus syndrome
* Second and third degree A-V block
* Pulmonary hypertension
* Right ventricular failure secondary to pulmonary hypertension
* Decompensated heart failure
* Cardiogenic shock
* Nontreated pheochromocytoma
* Known hypersensitivity to esmolol or any of the inactive ingredients of the product
* Allergy to esmolol or other beta blockers (cross-sensitivity is possible)
* Renal dysfunction
* Airway disease such as asthma or chronic obstructive pulmonary disease
* Thyrotoxicosis
* Myasthenia gravis
* Raynaud's disease or peripheral circulatory disorder
Other situations leading to exclusion :
* Severe mental impairment
* Chronic use of opioids, β-adrenergic receptors antagonists
* High risk of conversion to laparotomy according to the surgical team (\>25%)
Patients will automatically be excluded after recruitment if they withdraw their consent, or if laparoscopy is converted to laparotomy.
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