[Sodium nitroprusside-induced hypotension for pediatric orthopedic surgery]

Induced hypotensive anesthesia is a well established technique in adult patients. We examined retrospectively the effect of sodium nitroprusside pediatric patients undergoing pelvic osteotomy with simultaneous femoral osteotomy.

Twenty-three patients received sodium nitroprusside-induced hypotensive anesthesia (group N) and 14 patients received standard anesthesia (group C). In patients of Group N, a target mean arterial blood pressure of 50-60 mmHg was achieved by intravenous administration of sodium nitroprusside.

Significant differences were observed between the two groups in the amounts of intra-operative blood loss and fluid infusion. Group N had less intra-operative blood loss than Group C (Group N: 7.3 +/- 4.1 ml x kg(-1) vs. Group C: 10.9 +/- 4.0 ml x kg(-1), P<0.05). Group N had less intra-operative fluid infusion than Group C (Group N: 37.7 +/- 11.2 ml x kg(-1) vs. Group C: 53.9 +/- 15.0 ml x kg(-1), P<0.05). Urine output was not significantly different (Group N: 6.0 +/- 6.2 ml x kg(-1) vs. Group C: 7.0 +/- 5.7 ml x kg(-1), P=0.60). There were no side effects of sodium nitroprusside-induced hypotension.

These results suggest that sodium nitroprusside is a safe and effective drug for induced hypotension in pediatric patients.