Document Detail

Controlled hypotension in adults undergoing choroidal melanoma resection: comparison between the efficacy of nitroprusside and magnesium sulphate.
MedLine Citation:
PMID:  18538047     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: To determine whether magnesium sulphate could induce controlled hypotension, reduce choroidal blood flow, provide a 'dry' operative field and could be compared with sodium nitroprusside in the recently raised issue of the use of hypotensive anaesthesia in eye surgery, i.e. for choroidal tumour surgery as the choroid is the most fragile and vascular structure in the eye. METHODS: Forty adult patients undergoing choroidal melanoma resection and anaesthetized with 2.5 mg kg(-1) propofol, followed by a constant infusion of 120 microg kg(-1) min(-1), and remifentanil 1 microg kg(-1), followed by a continuous infusion of 0.25 microg kg(-1) min(-1), were randomly assigned to two groups to receive either magnesium sulphate or sodium nitroprusside. RESULTS: Controlled hypotension was achieved at the target systolic pressure of 80 mmHg within 107 +/- 16 and 69 +/- 4.4 s for magnesium sulphate and sodium nitroprusside, respectively. Choroidal blood flow decreased by 24 +/- 0.3% and 22 +/- 3.3% for magnesium sulphate and sodium nitroprusside, respectively. Controlled hypotension was sustained in both groups throughout surgery, and the surgical field rating decreased in a range of 80% in both groups. Sodium nitroprusside decreased pH and increased PaCO2. There were no postoperative complications in any of the groups. CONCLUSION: Magnesium sulphate controlled hypotension, reduced intraoperative pressure and provided good surgical conditions for choroidal melanoma resection with no need for additional use of a potent hypotensive agent in adults.
M Yosry; I S Othman
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-06-09
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  25     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-07     Completed Date:  2009-02-03     Revised Date:  2009-03-19    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  891-6     Citation Subset:  IM    
Cairo University, Faculty of Medicine, Department of Anesthesiology, Cairo, Egypt.
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MeSH Terms
Anesthetics, Intravenous / administration & dosage
Blood Pressure
Choroid Neoplasms / surgery*
Heart Rate
Hypotension / therapy*
Magnesium Sulfate / pharmacology*
Melanoma / surgery*
Nitroprusside / pharmacology*
Postoperative Complications
Propofol / administration & dosage*
Time Factors
Reg. No./Substance:
0/Anesthetics, Intravenous; 15078-28-1/Nitroprusside; 2078-54-8/Propofol; 7487-88-9/Magnesium Sulfate

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