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KMID : 0356920060500000031
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Korean Journal of Anesthesiology
2006 Volume.50 No. 0 p.31 ~ p.35
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Effects of Hydralazine Pretreatment on Esmolol-induced Controlled Hypotension during Spine Surgery
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Park Kum-Suk
Roh Young-Jin
Kim Jong-Su
Do Sang-Hwan
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Abstract
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Background: Controlled hypotension improves surgical field and decreases transfusion requirement in surgical patients and can be induced with various kinds of drugs including esmolol and hydralazine.
Methods: This study examined the effect of a combination of esmolol and hydralazine as hypotensive agents in spine surgery. In the esmolol group (n = 15), after boluses of esmolol (0.5 mg/kg) injection, esmolol was infused to maintain the mean arterial pressure of 55-65 mmHg. In the hydralazine-esmolol group (n = 15), hydralazine (0.3 mg/kg) was administered 15 minutes before esmolol injection which was done in the same way as that of the esmolol group.
Results: The mean arterial pressure decreased to the target range more rapidly in the hydralazine-esmolol group. The heart rate was increased by hydralazine, but reduced by esmolol. The cardiac output remained elevated after hydralazine injection in the hydralazine-esmolol group, and decreased significantly by esmolol in the esmolol group. The administered dose of esmolol was much less in the hydralazine-esmolol group than in the esmolol group.
Conclusions: Our data suggest that hydralazine can enhance the efficacy of esmolol-induced controlled hypotension. It can reduce the requirement of esmolol and maintain a higher cardiac output during Hypotension.
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KEYWORD
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controlled hypotension, esmolol, hydralazine
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