COMAPARATIVE STUDY BETWEEN SODIUM NITROPRUSSIDE AND . URAPIDIL FOR THE CONTROL OF HYPERTENSION IN OPEN-HEART SURGERY
Sherine Kamal Zaki Kodeira;
Abstract
Group SNP received SNP at an initial rate of 1-2
J.!glkg/min; group URA received one or more bolus injections of urapedil 25 mg and IV infusion at an initial rate of 11-21
J.!g/kg/min.
Baseline measurements were obtained 10 minutes after introduction of an echotransducer into the oesophagus. Infusion • rates were adjusted to maintain systolic arterial pressure at 80-120% of baseline values or mean arterial pressure < 100 mm Hg. Additional measurements were obtained 10 minutes after the start of vasodilator therapy and after sternotomy when the pericardium was spared then fourth measurement post bypass. At each measuring time, a complete haemodynamic profile: SBP, DBP, MAP, MPAP, • PCWP, RPP, cortisol level, transoesophageal echocardiographic images, and arterial and coronary venous samples were obtained.
After sternotomy, heart rate increased in SNP group. URA group showed stability in HR whereas bradycardia is encountered with few cases. At that time, a decrease in myocardial oxygen consumption and CSBF in group URA is presumed. However, the ratio between myocardial demand and oxygen supply remained unchanged and there was no difference in the number of ischemic episodes between the two groups (Br. J. Anaesth., 1996) .
• SNP is a classic drug for the management of perioperative hypertension. However SNP is known to induce
several undesirable effects including reflex tachycardia, intrapulmonary and intracoronary shunting, tachyphylaxis and cyanide toxicity (Vesey et al., 1985).
J.!glkg/min; group URA received one or more bolus injections of urapedil 25 mg and IV infusion at an initial rate of 11-21
J.!g/kg/min.
Baseline measurements were obtained 10 minutes after introduction of an echotransducer into the oesophagus. Infusion • rates were adjusted to maintain systolic arterial pressure at 80-120% of baseline values or mean arterial pressure < 100 mm Hg. Additional measurements were obtained 10 minutes after the start of vasodilator therapy and after sternotomy when the pericardium was spared then fourth measurement post bypass. At each measuring time, a complete haemodynamic profile: SBP, DBP, MAP, MPAP, • PCWP, RPP, cortisol level, transoesophageal echocardiographic images, and arterial and coronary venous samples were obtained.
After sternotomy, heart rate increased in SNP group. URA group showed stability in HR whereas bradycardia is encountered with few cases. At that time, a decrease in myocardial oxygen consumption and CSBF in group URA is presumed. However, the ratio between myocardial demand and oxygen supply remained unchanged and there was no difference in the number of ischemic episodes between the two groups (Br. J. Anaesth., 1996) .
• SNP is a classic drug for the management of perioperative hypertension. However SNP is known to induce
several undesirable effects including reflex tachycardia, intrapulmonary and intracoronary shunting, tachyphylaxis and cyanide toxicity (Vesey et al., 1985).
Other data
| Title | COMAPARATIVE STUDY BETWEEN SODIUM NITROPRUSSIDE AND . URAPIDIL FOR THE CONTROL OF HYPERTENSION IN OPEN-HEART SURGERY | Other Titles | دراسة مقارنة بين عقارى الصوديوم نيتروبروسايد واليورابيديل لخفض ضغط الدم المرتفع فى جراحة القلب المفتوح | Authors | Sherine Kamal Zaki Kodeira | Issue Date | 2000 |
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