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[Clinical study on hypotensive anesthesia with nitroglycerin].

M Kurokawa, M Ogata, H Takara

    Journal of UOEH
    |September 1, 1985
    PubMed
    Summary

    Nitroglycerin effectively induced deliberate hypotension for intracranial aneurysm surgery, showing smooth blood pressure control and no resistance. While heart rate increased, myocardial oxygen demand decreased, though pulmonary oxygenation was reduced.

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    Area of Science:

    • Neurosurgery
    • Anesthesiology
    • Cardiovascular Physiology

    Context:

    • Intracranial aneurysm clipping surgery requires precise hemodynamic control.
    • Deliberate hypotension is a technique used to reduce intraoperative bleeding and improve surgical visualization.
    • Nitroglycerin is a vasodilator that can be used to induce hypotension.

    Purpose:

    • To evaluate the efficacy and safety of nitroglycerin for inducing deliberate hypotension in patients undergoing intracranial aneurysm clipping surgery.

    Summary:

    • Nitroglycerin (NG) administration resulted in rapid and smooth blood pressure changes during induced hypotension.
    • No patient resistance to NG was observed.
    • A significant increase in heart rate and a decrease in rate-pressure product (RPP), indicative of reduced myocardial oxygen demand, were noted.

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  • While arterial blood gas parameters remained stable, the respiratory index (PaO2/FIO2) significantly decreased, suggesting reduced pulmonary oxygenation.

    • Impact:

    • Nitroglycerin is a viable option for inducing deliberate hypotension in neurosurgery.
    • Monitoring myocardial oxygen demand and pulmonary oxygenation is crucial during NG-induced hypotension.
    • Further research is needed to explore strategies for mitigating the reduction in pulmonary oxygenation.