[Value of glyceryl trinitrate during the intraoperative period in patients operated on for coronary disease. Study of changes in the arterial pressure and heart rate].
The aim of this study was to determine the changes in systemic blood pressure and heart rate observed at induction and during the immediate postoperative period in patients suffering from coronary artery disease who received a percutaneous preparation of nitroglycerin (PCNG) pre-operatively. In this randomized study, 23 patients with mild coronary disease were divided into two groups: in the 12 patients of group I, 30 mg of PCNG were applied 30 minutes before induction. The 11 patients of group II received a placebo. A slight increase in heart rate at induction, and a modest but significant decrease in systolic blood pressure both 15 minutes after application of PCNG and at induction were noted in group I. Systolic blood pressure increased during intubation in group II (placebo), but not in group I (PCNG). The systolic blood pressure recorded 5 minutes after extubation was greater in group II (placebo) than in group I (PCNG): X +/- SD: 141 +/- 13 vs 128 +/- 10 (P less than 0.01). Nitrate therapy should not be discontinued during the operative period in patients receiving oral nitrates for coronary disease; PCNG is a simple measure, particularly suitable for maintaining nitrate therapy in such patients. When administered before induction during the operative period, PCNG provoked neither tachycardia nor important decrease in systolic blood pressure which would mask the potentially beneficial effects of nitroglycerin.
D000287:Administration, Topical; D001794:Blood Pressure / Q000187:drug effects*; D003327:Coronary Disease / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000494:pharmacology; D011292:Premedication
D005996:Nitroglycerin
Intérêt de la trinitrine percutanée pendant la période opératoire chez l'opéré coronarien. Etude des modifications de la pression artérielle et de la fréquence cardiaque.