[Urapidil in anesthesiology: pharmacology and indications]

This review aims to describe the pharmacological bases for using urapidil, a recently introduced hipotensor, and to survey the literature on its therapeutic possibilities. The anesthesiologist often sees hypertension during surgery and must apply hypotensive treatment to prevent complications. Urapidil works mainly by antagonizing postsynaptic alpha-1-adrenergic receptors and stimulating 5-HT1A receptors, a double mechanism that provides vasodilation with moderate decrease in blood pressure without reflex tachycardia. Adverse side effects are rare and clinically unimportant. Onset is rapid after intravenous administration and duration of action is short; dose can be easily adjusted based on response and patient requirements. While urapidil has been used successfully in a variety of diseases and surgical procedures, its pharmacological characteristics make it particularly useful in patients at high cardiovascular risk or undergoing neurosurgery, in which results are good. Although the oral form is not sold in Spain, it is used in other countries to treat chronic high blood pressure. Urapidil is a hypotensor with a wide range of indications (critical hypertension, prophylaxis for hypertensive peaks and treatment of hypertension during surgery) and few side effects.