Attenuation of the cardiovascular responses to subcutaneous adrenaline in neurosurgical patients.
In 30 neurosurgical patients after induction of anaesthesia and random pretreatment with i.v. propranolol 1 mg or metoprolol 1 mg, heart rate and mean arterial pressure were measured at 30-s intervals after subcutaneous infiltration of adrenaline 1:200,000. While metoprolol prevented the cardiovascular effects of adrenaline infiltration, propranolol pretreatment was associated with a highly significant increase (P less than 0.01) in mean arterial pressure and a significant decrease (P less than 0.05) in heart rate. These results confirm the potentially serious interaction of propranolol and adrenaline during anaesthesia, and support the use of metoprolol instead, to obtund the cardiovascular effects of adrenaline infiltration.
Muralidhar
K
K
Department of Anaesthesia, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India.
Bhanumurthy
S
S
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects*; D001921:Brain / Q000601:surgery*; D004347:Drug Interactions; D004837:Epinephrine / Q000037:antagonists & inhibitors*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007279:Injections, Subcutaneous; D008790:Metoprolol / Q000494:pharmacology*; D009638:Norepinephrine / Q000008:administration & dosage; D011292:Premedication; D011433:Propranolol / Q000494:pharmacology*
D011433:Propranolol; D008790:Metoprolol; D009638:Norepinephrine; D004837:Epinephrine