Document Detail


Esmolol for potentiation of nitroprusside-induced hypotension: impact on the cardiovascular, adrenergic, and renin-angiotensin systems in man.
MedLine Citation:
PMID:  2569849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Esmolol infusion at rates of 200, 300, and 400 micrograms.kg-1.min-1 was used to potentiate hypotension (mean arterial pressure = 60 mm Hg) induced with sodium nitroprusside (SNP) in 10 male patients undergoing radical cancer surgery during nitrous oxide-oxygen and fentanyl anesthesia. Heart rate (HR), blood pressure (radial arterial catheter), and plasma levels of renin activity (PRA), norepinephrine (N), epinephrine (E), and dopamine (D) were measured: 1) while patients were awake; 2) after induction of anesthesia (nitrous oxide, 60% in oxygen, fentanyl = 5 micrograms/kg followed by an infusion at 10 micrograms.kg-1.hr-1); 3) after surgery had begun; 4) after 20 minutes of SNP-induced hypotension; 5) after 20 minutes of esmolol at each of the above infusion rates; and 6) after the completion of surgery. Compared to awake values, SNP-induced hypotension (mean infusion rate = 3.1 micrograms.kg-1.min-1 +/- 0.6 SE) during surgery resulted in significant (P less than 0.05) increases in heart rate, PRA, N, and D. Infusion of esmolol resulted in significant (P less than 0.05) dose-dependent reductions in SNP requirement to maintain MAP = 60 mm Hg. At 200 micrograms.kg-1.min-1, SNP requirement was 2.1 micrograms.kg-1.min-1 +/- 0.4, at 300 micrograms.kg-1.min-1, it was 1.0 micrograms.kg-1.min-1 +/- 0.2, and at 400 micrograms.kg-1.min-1, was 0.5 micrograms.kg-1.min-1 +/- 0.3. Concomitant with the decrease in SNP requirement, there were significant reductions in HR and PRA at all infusion rates of esmolol.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R Edmondson; O Del Valle; N Shah; G Wong; D Dwyer; D Matarazzo; A Thorne; C Coffey; R Bedford
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  69     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1989 Aug 
Date Detail:
Created Date:  1989-09-12     Completed Date:  1989-09-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  202-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / administration & dosage,  pharmacology*
Adult
Aged
Blood Pressure / drug effects
Catecholamines / blood
Drug Synergism
Ferricyanides / pharmacology*
Heart Rate / drug effects*
Humans
Hypotension, Controlled*
Male
Middle Aged
Nitroprusside / administration & dosage,  pharmacology*
Oxygen / blood
Propanolamines / administration & dosage,  pharmacology*
Receptors, Adrenergic, beta / drug effects*
Renin / blood
Renin-Angiotensin System / drug effects*
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Catecholamines; 0/Ferricyanides; 0/Propanolamines; 0/Receptors, Adrenergic, beta; 15078-28-1/Nitroprusside; 7782-44-7/Oxygen; 84057-94-3/esmolol; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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