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Labetalol to control blood pressure after cerebrovascular surgery.
Crit Care Med. 1988 Aug; 16(8):765-8.CC

Abstract

Fifteen patients who had undergone neurovascular surgery for arteriovenous malformations or cerebrovascular aneurysms and had intracranial pressure (ICP) monitors were studied. The patients had been treated initially with sodium nitroprusside to maintain their arterial BP in a prescribed range, but, because of excessive nitroprusside dose requirements, they were considered either to have refractory BP or to be at risk for thiocyanate toxicity. Intravenous labetalol therapy was started either by frequent bolus pulse therapy every 1 to 2 h or by continuous infusion therapy. The degree of desired arterial BP control and the effects on ICP and cerebral perfusion pressure (CPP) were assessed and compared with the results during nitroprusside therapy. The degree of arterial BP control with labetalol was assessed to be good; 11 patients were weaned off nitroprusside and the remaining four patients had a substantial reduction in their nitroprusside requirements, needing an average of only 1.5 micrograms/kg.min of nitroprusside to control their BP compared with average requirements of 10 micrograms/kg.min of nitroprusside before labetalol therapy. Labetalol therapy improved CPP in six patients and ICP in five patients, with no significant change in cerebral pressure in the remainder. Overall, the CPP in the 15 patients improved from 63 +/- 15 (SD) mm Hg with nitroprusside to 65 +/- 10 mm Hg with labetalol therapy and the ICP decreased from 11.3 +/- 6.1 mm Hg with nitroprusside to 8.6 +/- 3.1 mm Hg with labetalol therapy (p less than .05 by Wilcoxon matched pairs).(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Orlowski JP
Division of Anesthesiology, Cleveland Clinic Foundation, OH 44106.
Shiesley D
No affiliation info available
Vidt DG
No affiliation info available
Barnett GH
No affiliation info available
Little JR
No affiliation info available

MeSH

AdolescentAdultAgedArteriovenous MalformationsBrainFemaleHumansHypertensionInfusions, IntravenousInjections, IntravenousIntracranial AneurysmIntracranial PressureLabetalolMaleMiddle AgedNitroprussidePostoperative Complications

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

3396371

Citation

Orlowski, J P., et al. "Labetalol to Control Blood Pressure After Cerebrovascular Surgery." Critical Care Medicine, vol. 16, no. 8, 1988, pp. 765-8.
Orlowski JP, Shiesley D, Vidt DG, et al. Labetalol to control blood pressure after cerebrovascular surgery. Crit Care Med. 1988;16(8):765-8.
Orlowski, J. P., Shiesley, D., Vidt, D. G., Barnett, G. H., & Little, J. R. (1988). Labetalol to control blood pressure after cerebrovascular surgery. Critical Care Medicine, 16(8), 765-8.
Orlowski JP, et al. Labetalol to Control Blood Pressure After Cerebrovascular Surgery. Crit Care Med. 1988;16(8):765-8. PubMed PMID: 3396371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Labetalol to control blood pressure after cerebrovascular surgery. AU - Orlowski,J P, AU - Shiesley,D, AU - Vidt,D G, AU - Barnett,G H, AU - Little,J R, PY - 1988/8/1/pubmed PY - 1988/8/1/medline PY - 1988/8/1/entrez SP - 765 EP - 8 JF - Critical care medicine JO - Crit Care Med VL - 16 IS - 8 N2 - Fifteen patients who had undergone neurovascular surgery for arteriovenous malformations or cerebrovascular aneurysms and had intracranial pressure (ICP) monitors were studied. The patients had been treated initially with sodium nitroprusside to maintain their arterial BP in a prescribed range, but, because of excessive nitroprusside dose requirements, they were considered either to have refractory BP or to be at risk for thiocyanate toxicity. Intravenous labetalol therapy was started either by frequent bolus pulse therapy every 1 to 2 h or by continuous infusion therapy. The degree of desired arterial BP control and the effects on ICP and cerebral perfusion pressure (CPP) were assessed and compared with the results during nitroprusside therapy. The degree of arterial BP control with labetalol was assessed to be good; 11 patients were weaned off nitroprusside and the remaining four patients had a substantial reduction in their nitroprusside requirements, needing an average of only 1.5 micrograms/kg.min of nitroprusside to control their BP compared with average requirements of 10 micrograms/kg.min of nitroprusside before labetalol therapy. Labetalol therapy improved CPP in six patients and ICP in five patients, with no significant change in cerebral pressure in the remainder. Overall, the CPP in the 15 patients improved from 63 +/- 15 (SD) mm Hg with nitroprusside to 65 +/- 10 mm Hg with labetalol therapy and the ICP decreased from 11.3 +/- 6.1 mm Hg with nitroprusside to 8.6 +/- 3.1 mm Hg with labetalol therapy (p less than .05 by Wilcoxon matched pairs).(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/3396371/Labetalol_to_control_blood_pressure_after_cerebrovascular_surgery_ DB - PRIME DP - Unbound Medicine ER -