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A comparison of labetalol and nitroprusside for inducing hypotension during major surgery.
Anesth Analg. 1990 May; 70(5):537-42.A&A

Abstract

The hemodynamic and intrapulmonary shunt effects of intravenous labetalol and nitroprusside were compared during induced hypotension for major spinal surgery. A randomized, double-blind protocol was used in which 20 patients, ASA physical status I or II, received either nitroprusside infusion (n = 10) or labetalol bolus injections of 10 mg every 10 min (n = 10) until mean arterial blood pressure was reduced to 55-60 mm Hg. Pulmonary artery pressures were measured and mixed venous samples obtained via a pulmonary artery catheter. Nitroprusside increased heart rate significantly more than labetalol during the period of hypotension. When compared with prehypotension baseline values, nitroprusside increased heart rate significantly with a concomitant significant decrease in systemic vascular resistance. Cardiac output increased significantly 60 min after hypotension was achieved in patients treated with nitroprusside. Systemic vascular resistance decreased significantly below baseline levels in patients treated with labetalol but without changes in cardiac output, heart rate, or mean pulmonary artery pressure. There was a 122% increase in intrapulmonary shunt with nitroprusside administration, compared with an 11% increase with labetalol. Labetalol was effective for inducing hypotension and was not associated with an increase in heart rate, intrapulmonary shunt, or cardiac output as seen with nitroprusside.

Authors+Show Affiliations

Goldberg ME
Department of Anesthesiology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania.
McNulty SE
No affiliation info available
Azad SS
No affiliation info available
Cantillo J
No affiliation info available
Torjman M
No affiliation info available
Marr AT
No affiliation info available
Huffnagle S
No affiliation info available
Seltzer JL
No affiliation info available

MeSH

AdultAnesthesia, GeneralDouble-Blind MethodDrug EvaluationFemaleFerricyanidesHemodynamicsHumansHypotension, ControlledIsofluraneLabetalolMaleMiddle AgedNitroprussideRandom AllocationSpinal Diseases

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2082945

Citation

Goldberg, M E., et al. "A Comparison of Labetalol and Nitroprusside for Inducing Hypotension During Major Surgery." Anesthesia and Analgesia, vol. 70, no. 5, 1990, pp. 537-42.
Goldberg ME, McNulty SE, Azad SS, et al. A comparison of labetalol and nitroprusside for inducing hypotension during major surgery. Anesth Analg. 1990;70(5):537-42.
Goldberg, M. E., McNulty, S. E., Azad, S. S., Cantillo, J., Torjman, M., Marr, A. T., Huffnagle, S., & Seltzer, J. L. (1990). A comparison of labetalol and nitroprusside for inducing hypotension during major surgery. Anesthesia and Analgesia, 70(5), 537-42.
Goldberg ME, et al. A Comparison of Labetalol and Nitroprusside for Inducing Hypotension During Major Surgery. Anesth Analg. 1990;70(5):537-42. PubMed PMID: 2082945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of labetalol and nitroprusside for inducing hypotension during major surgery. AU - Goldberg,M E, AU - McNulty,S E, AU - Azad,S S, AU - Cantillo,J, AU - Torjman,M, AU - Marr,A T, AU - Huffnagle,S, AU - Seltzer,J L, PY - 1990/5/1/pubmed PY - 1990/5/1/medline PY - 1990/5/1/entrez SP - 537 EP - 42 JF - Anesthesia and analgesia JO - Anesth Analg VL - 70 IS - 5 N2 - The hemodynamic and intrapulmonary shunt effects of intravenous labetalol and nitroprusside were compared during induced hypotension for major spinal surgery. A randomized, double-blind protocol was used in which 20 patients, ASA physical status I or II, received either nitroprusside infusion (n = 10) or labetalol bolus injections of 10 mg every 10 min (n = 10) until mean arterial blood pressure was reduced to 55-60 mm Hg. Pulmonary artery pressures were measured and mixed venous samples obtained via a pulmonary artery catheter. Nitroprusside increased heart rate significantly more than labetalol during the period of hypotension. When compared with prehypotension baseline values, nitroprusside increased heart rate significantly with a concomitant significant decrease in systemic vascular resistance. Cardiac output increased significantly 60 min after hypotension was achieved in patients treated with nitroprusside. Systemic vascular resistance decreased significantly below baseline levels in patients treated with labetalol but without changes in cardiac output, heart rate, or mean pulmonary artery pressure. There was a 122% increase in intrapulmonary shunt with nitroprusside administration, compared with an 11% increase with labetalol. Labetalol was effective for inducing hypotension and was not associated with an increase in heart rate, intrapulmonary shunt, or cardiac output as seen with nitroprusside. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/2082945/A_comparison_of_labetalol_and_nitroprusside_for_inducing_hypotension_during_major_surgery_ DB - PRIME DP - Unbound Medicine ER -