[Control of arterial pressure in aortic coarctation surgery]

After reporting personal experience in the pharmacological control of intraoperative hypertension in 14 patients with aortic coarctation, 7 of them treated with trimetaphan (TMF) and 2 with nitroprussiate of sodium (NPS), stress is laid on the advantages of NPS in comparison with TMF, namely as regards speed of induction, prompt reversibility of action and lesser interference with the haemodynamics of the renal and coronary circulations. Attention is also called to the collateral effects, such as reflex cardiostimulation, which may require the use of beta-blocking drugs, and cyanide-induced toxicity which demands dose limitation (0.5 mg/kg/h). NPS is considered the drug of choice in those situations which require emergency pressure control and in controlled hypotension, for which TMF was used in the past.