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Related Experiment Videos

Nitroprusside, its metabolites and red cell function.

J du Cailar, J C Mathieu-Daude, J Deschodt

    Canadian Anaesthetists' Society Journal
    |March 1, 1978
    PubMed
    Summary
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    Sodium nitroprusside (SNP) infusion during surgery increases blood cyanide levels, primarily within red blood cells, without significantly affecting metabolism or red cell function. Higher SNP doses may lead to toxic cyanide levels.

    Area of Science:

    • Anesthesiology
    • Clinical Pharmacology
    • Toxicology

    Background:

    • Sodium nitroprusside (SNP) is used to induce controlled hypotension (CH) during surgery.
    • SNP metabolism releases cyanide (CN-) and thiocyanate (SCN-), raising concerns about their toxicity.
    • Understanding the impact of SNP-induced CN- and SCN- on red blood cells and metabolism is crucial.

    Purpose of the Study:

    • To investigate the effects of SNP-induced controlled hypotension on blood thiocyanate and cyanide levels.
    • To assess the impact of these metabolites on red blood cell function and metabolic parameters.
    • To determine safe dosage limits for SNP during surgical procedures.

    Main Methods:

    • Studied 42 patients undergoing surgery with SNP-induced controlled hypotension.

    Related Experiment Videos

  • Measured blood levels of thiocyanate (SCN-) and cyanide (CN-) during and after SNP infusion.
  • Assessed red blood cell function, carbonic anhydrase activity, 2,3-DPG, blood gases, acid-base balance, and lactate levels.

    • Main Results:

    • SNP infusion led to a slight increase in blood SCN- and significant increases in blood CN-, mainly within red blood cells.
    • Red blood cell function, carbonic anhydrase activity, 2,3-DPG, blood gases, and acid-base balance remained largely unaffected at clinical concentrations.
    • A slight increase in blood lactate was observed, but CN- levels did not reach toxic thresholds for carbonic anhydrase.
    • The study identified potential toxic levels for SNP dosage based on a toxicity study.

    Conclusions:

    • SNP infusion during surgery results in detectable blood CN- levels, primarily sequestered in red blood cells, without compromising their function or causing significant metabolic disturbances at the studied doses.
    • Plasma CN- concentrations remained below levels likely to cause major metabolic issues.
    • Caution is advised with higher SNP dosages, as they may elevate CN- to toxic levels, suggesting dosage limits of 1.16 mg/kg or 10 microgram/kg/min for two hours.