Enalaprilat controls postoperative hypertension while maintaining cardiac function and systemic oxygenation after neurosurgery.
OBJECTIVE
The efficacy of intravenous enalaprilat in lowering postoperative hypertension.


METHODS
Prospective, randomized, controlled, single blind trial.


METHODS
Surgical ICT in a university hospital (tertiary care center).


METHODS
18 neurosurgical patients subjected to the extirpation of a supratentorial intracerebral tumour were studied after detection of postoperative hypertension. This was defined as a constant elevation of systolic arterial pressure over 160 mmHg or diastolic arterial pressure over 95 mmHg.


METHODS
Enalaprilat 0.015 mg kg-1 was injected within 5 min to 9 patients.


RESULTS
Central haemodynamics and systemic oxygenation were assessed at baseline before enalaprilat injection, and repeatedly during four hours after the injection. The statistical analysis was performed with analysis of variance for repeated measurements. As compared to control patients, the blood pressure lowering effect of enalaprilat became evident within 15 min and lasted for over four hours (p = 0.008). It was mainly due to the reduced systemic vascular resistance. Enalaprilat also induced a small decline in myocardial perfusion pressure. Cardiac performance, preload, heart rate and systemic oxygenation were not affected by enalaprilat.


CONCLUSIONS
We found intravenous enalaprilat effective and safe in lowering postoperative hypertension following neurosurgery as assessed by it's effects on central haemodynamics and systemic oxygenation.
Tohmo
H
H
Cardiorespiratory Research Unit, University of Turku, Finland.
Karanko
M
M
D000328:Adult; D000704:Analysis of Variance; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D002302:Cardiac Output / Q000187:drug effects*; D015773:Enalaprilat / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006334:Heart Function Tests; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects*; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D015173:Supratentorial Neoplasms / Q000601:surgery*
D000806:Angiotensin-Converting Enzyme Inhibitors; D015773:Enalaprilat