title: Obstetric use of nitroglycerin: Anesthetic implications.
abstract: Nitroglycerin has been used in anesthetic practice for induced hypotension and managing perioperative hypertension and myocardial ischemia. Contrary to the continuous low dose infusions (5-20 mcg/min) used for the same, intravenous bolus dosages are sometimes administered at the behest of obstetricians for removal of retained placenta. Use of nitroglycerine in managing retained placenta is undertaken as a last resort when other measures fail to relax the uterine smooth muscles. Intravenous nitroglycerine relaxes smooth muscle cells by releasing nitric oxide thus causing prompt cervico-uterine relaxation. However, administration of nitroglycerine in this manner is not without risks which should be kept in mind while using it for obstetric purposes. We hereby report a case of 22-year-old female scheduled for manual removal of placenta where unpredictable and unexpected hypoxemia was observed following nitroglycerine administration.
authors.affiliation: Department of Anesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Richa
authors.initials: R
authors.lastname: Saroa
authors.forename: Shikha
authors.initials: S
authors.lastname: Sachan
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Palta
authors.forename: Satinder
authors.initials: S
authors.lastname: Gombar
authors.forename: Nitika
authors.initials: N
authors.lastname: Sahai
keywords: Hypoxemia; nitroglycerine; obstetrics