[Usefulness of urapidil during intraoperative rise of arterial blood pressure in patients operated under general anesthesia].
METHODS
Urapidil was administered in 69 patients aged between 46-79 age (average 62.7 +/- 8.4 age) to control intra-operative increase in arterial blood pressure accompanying endotracheal intubation, extubation, wakening of the patients, incision of abdominal integument and clamping of abdominal aorta. In presented group 47 patients suffered from arterial hypertension and 22 patients did not. Patients underwent various surgical procedures in general anesthesia and in 13 patients implantation of aortal prosthesis in result of abdominal aortic aneurysm (7 patients) and Leriche syndrome (5 patients) was performed.


RESULTS
Urapidil turned out to be efficacious in 56 patients (81.1%), in 40 patients with previously diagnosed arterial hypertension and 16 patients who did not suffer from hypertension. In 13 other patients (18.9%) monotherapy with urapidil brought a desired hemodynamic effect and infusion of nitroglycerine was necessary. In a group of patients receiving urapidil during monotherapy, the average dosage of the medicine required to lower arterial blood pressure amounted to 26.3 +/- 2.4 mg, and respectively in patients with arterial hypertension 30.5 +/- 3.5 mg, and in patients without arterial hypertension to 22.1 +/- 4.5 mg and desired reduction of pressure was obtained on average after 11.2 +/- 3.4 minutes. Reduction of systolic pressure amounted on average to 30.5 +/- 13.5 mmHg (4.0 +/- 1.4 kPa) whereas diastolic pressure to 15.5 +/- 7.5 mmHg (2.0 +/- 1.0 kPa). In 13 patients subject to the administration of 83.7 +/- 6.5 mg of urapidil, on average desired effected was not achieved and it was necessary to infuse nitroglycerin. Among these patients reduction of systolic (average 35.3 +/- 10.7 mmHg/4.7 +/- 1.4 kPa) and diastolic pressure (average 16.7 +/- 8.3 mmHg/2.2 +/- 1.1 kPa) was obtained after 16.3 +/- 5.1 minutes on average. In patients receiving urapidil during monotherapy no acceleration of heart beat per minute was observed. On the other hand significant increase (p < 0.05) by 16.8 +/- 8.2 per minute was registered in patients receiving urapidil with nitroglycerine and it was significantly higher (p < 0.05) in patients not suffering from arterial hypertension. None of the patients suffered from arrhythmia. In 2 patients undergoing operation complications occurred within the area of abdominal aorta as ischemia of myocardium.


CONCLUSIONS
Urapidil administered during monotherapy turned out to be efficacious in 81.1% of treated patients. Other 18.9% required an additional infusion of nitroglycerine, but these were patients operated on due to abdominal aorta. Average dosage of urapidil applied during monotherapy amounted to 26.3 +/- 2.4 mg. Intraoperative administration of urapidil did not result in acceleration of heart rate, and urapidil turned out to be a safe medicine to reduce intraoperative increase in arterial blood pressure also in patients who were previously diagnosed as suffering from arterial hypertension.
Grabowska-Gaweł
Anna
A
Zakład Pielegniarstwa w Intensywnej Opiece Medycznej Collegium Medicum im. L. Rydygiera UMK, Toruniu. angrabgaw@wp.pl
Porzych
Katarzyna
K
Grześk
Grzegorz
G
D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007431:Intraoperative Complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D010879:Piperazines; C015568:urapidil