[Controlled hypotension with sodium nitroprusside in neurosurgical patients (author's transl)]

Sodium Nitroprusside (Nipride) was administered by infusion pump intravenously in 27 neurosurgical patients for intraoperative, postoperative and posttraumatic blood pressure lowering. This was accomplished with intension to reduce the risk of hemorrhage during operation on highly vascularized tumors or aneurysms and to combat hypertensive crisis after surgery and brain injury. The effect was documented by direct arterial blood pressure registration and the drug proved to be fast acting, potent and readily reversible. Dosage varied between 1 and 10 microgram/kg/min with systolic pressure decreasing about 6 to 60% of the initial value. There was ill correlation between infusion rate and blood pressure drop which demanded particular caution at the beginning and the end of infusion. A decrease in pulse pressure and a moderate tachycardia were generally observed, however no complications were seen due to a Sodium Nitroprusside administration over less than 12 hours duration in our series.