Efficacy and safety of oral propranolol premedication to reduce reflex tachycardia during hypotensive anesthesia with sodium nitroprusside in orthognathic surgery: a double-blind randomized clinical trial.
OBJECTIVE
The present study sought to determine whether premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside could reduce reflex tachycardia, the amount of sodium nitroprusside used, and blood loss during hypotensive anesthesia for orthognathic surgery.


METHODS
A total of 60 patients undergoing bimaxillary surgery were studied in a prospective, randomized, and double-blind study of oral propranolol 10 mg or placebo as premedication before hypotensive anesthesia with sodium nitroprusside. Hemodynamic variables, the amount of sodium nitroprusside used, and blood loss were statistically analyzed.


RESULTS
The heart rate and amount of sodium nitroprusside used were highly significantly less (P < .01) in the propranolol group, but no significant difference was found in blood loss between the 2 groups. No clinically significant complications were observed in either group.


CONCLUSIONS
Premedication with oral propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside is safe and effective to reduce reflex tachycardia and the amount of sodium nitroprusside used.
Apipan
Benjamas
B
Department of Surgery, Mahidol University Faculty of Dentistry, Bangkok, Thailand. dtbap@mahidol.ac.th
Rummasak
Duangdee
D
D000284:Administration, Oral; D000328:Adult; D000768:Anesthesia, General; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D017704:Baroreflex / Q000187:drug effects; D016063:Blood Loss, Surgical; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007023:Hypotension, Controlled / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008297:Male; D009599:Nitroprusside / Q000008:administration & dosage / Q000494:pharmacology*; D056948:Orthognathic Surgical Procedures; D011292:Premedication; D011433:Propranolol / Q000008:administration & dosage*; D013610:Tachycardia / Q000209:etiology / Q000517:prevention & control*; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000494:pharmacology
D000889:Anti-Arrhythmia Agents; D014665:Vasodilator Agents; D009599:Nitroprusside; D011433:Propranolol