Intra-operative blood pressure control by prostaglandin E 1 in patients with hypertension and ischemic heart disease

Autor: Hoka, Sumio, Yoshitake, Junichi, Dan, Kenjiro, Goto, Yutaka, Honda, Natsuo, Morioka, Tohru, Muteki, Takesuke, Okuda, Yoshiro, Shigematsu, Akio, Takasaki, Mayumi, Totoki, Tadahide, Yoshimura, Nozomu
Zdroj: Journal of Anesthesia; April 1993, Vol. 7 Issue: 2 p173-183, 11p
Abstrakt: The purpose of this multi-center study was to evaluate the efficacy and safety of prostaglandin E 1 (PGE 1) administration in achieving deliberate hypotension and in treating intraoperative hypertension for patients with a history of hypertension and ischemic heart disease. PGE 1 (0.08 µg·kg −1·min −1) decreased systolic blood pressure from 125 ± 29 to 106 ± 22 mmHg (mean ± SD) in the deliberate hypotension group (n = 158) and from 155 ± 34 to 125 ± 32 mmHg in the antihypertension group (n = 55). The heart rate significantly increased from 80 ± 15 to 85 ± 18 beats·min −1 in the deliberate hypotension group, but was not significantly altered in the antihypertension group. The time required to obtain the desired level of blood pressure was approximately 20 min in the deliberate hypotension group. When the infusion was stopped, blood pressure returned approximately to the preinfusion level within about 20 min. No rebound hypertension was observed. PGE 1 significantly increased the urine flow in patients who had a low urine flow before PGE 1 infusion. Thirteen out of 213 patients (5.6%) had side effects such as excessive hypotension (1%), phlebitis (3%), and unexpected tachycardia (1%), which were alleviated gradually after discontinuation of PGE 1 infusion. No dysarrhythmia and further ST segment changes in the electrocardiograms were observed. These findings suggest that PGE 1 can be safely used to control arterial blood pressure during surgery in patients having preoperative hypertension and ischemic heart disease. (Hoka S, Yoshitake J, Dan K, et al.: Intra-operative blood pressure control by prostaglandin E 1 in patients with hypertension and ischemic heart disease. A multi-center study. J Anesth 7: 173–183, 1993)
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