TY - JOUR
T1 - Effects of propranolol on the cardiovascular and renin-angiotensin systems during hypotension produced by sodium nitroprusside in humans
AU - Marshall, W. K.
AU - Bedford, R. F.
AU - Arnold, W. P.
AU - Miller, E. D.
AU - Longnecker, D. E.
AU - Sussman, M. D.
AU - Hakala, M. W.
PY - 1981
Y1 - 1981
N2 - The authors examined the effects of controlled hypotension induced with sodium nitroprusside (SNP) with and without propranolol on the cardiovascular, pulmonary, and renin-angiotensin systems in 10 consecutive anesthetized patients with kyphoscoliosis undergoing posterior spinal fusion. SNP infusion (4.1 μg.kg-1.min-1) alone decreased mean systemic arterial pressure (SAP) by 25 torr ± 3 SE (P<0.001), systemic vascular resistance index (SVRI) by 1113 dyne.sec.cm-5.m2 ± 125 SE (P<0.001), mean pulmonary artery pressure (PAP) by 6 torr ± 2 SE (P<0.02), pulmonary capillary wedge pressure (PCWP) by 4 torr ± 1 SE (P<0.01), pulmonary vascular resistance (PVR) by 50 dyne.sec.cm-5 ± 18 (P<0.05), and Pa(O2) by 16 torr ± 7 SE (P<0.05), whereas cardiac index increased by 1.08 l.min-1 m2 ± 0.24 SE (P<0.01) and heart rate increased 16 beats/min ± 5 SE (P<0.02). After 40 min of hypotension, 0.03 mg/kg propranolol was injected intravenously while the SNP infusion rate was held constant. Ten min later there was a significant decrease in the heart rate (10 beats/min ± 4 SE, P<0.02) and cardiac index (0.65 l.min-1.min-1.m-2 ± 0.21, P<0.02). Plasma renin activity (PRA) increased from 2.37 ng.ml-1.h-1 ± 0.7 SE before anesthesia to 6.50 ng.ml-1.h-1 ± 1.45 SE (P<0.05) after 40 min of nitroprusside infusion. Forty min after propranolol there was a significant reduction in PRA to 4.07 ng.ml-1.h-1 ± 0.73 SE (P<0.05). Thus propranolol, when given during SNP hypotension, exhibits an early cardiovascular response manifested as a decrease in cardiac output and heart rate and a delayed action on the kidney resulting in an inhibition of renin release.
AB - The authors examined the effects of controlled hypotension induced with sodium nitroprusside (SNP) with and without propranolol on the cardiovascular, pulmonary, and renin-angiotensin systems in 10 consecutive anesthetized patients with kyphoscoliosis undergoing posterior spinal fusion. SNP infusion (4.1 μg.kg-1.min-1) alone decreased mean systemic arterial pressure (SAP) by 25 torr ± 3 SE (P<0.001), systemic vascular resistance index (SVRI) by 1113 dyne.sec.cm-5.m2 ± 125 SE (P<0.001), mean pulmonary artery pressure (PAP) by 6 torr ± 2 SE (P<0.02), pulmonary capillary wedge pressure (PCWP) by 4 torr ± 1 SE (P<0.01), pulmonary vascular resistance (PVR) by 50 dyne.sec.cm-5 ± 18 (P<0.05), and Pa(O2) by 16 torr ± 7 SE (P<0.05), whereas cardiac index increased by 1.08 l.min-1 m2 ± 0.24 SE (P<0.01) and heart rate increased 16 beats/min ± 5 SE (P<0.02). After 40 min of hypotension, 0.03 mg/kg propranolol was injected intravenously while the SNP infusion rate was held constant. Ten min later there was a significant decrease in the heart rate (10 beats/min ± 4 SE, P<0.02) and cardiac index (0.65 l.min-1.min-1.m-2 ± 0.21, P<0.02). Plasma renin activity (PRA) increased from 2.37 ng.ml-1.h-1 ± 0.7 SE before anesthesia to 6.50 ng.ml-1.h-1 ± 1.45 SE (P<0.05) after 40 min of nitroprusside infusion. Forty min after propranolol there was a significant reduction in PRA to 4.07 ng.ml-1.h-1 ± 0.73 SE (P<0.05). Thus propranolol, when given during SNP hypotension, exhibits an early cardiovascular response manifested as a decrease in cardiac output and heart rate and a delayed action on the kidney resulting in an inhibition of renin release.
UR - https://www.scopus.com/pages/publications/0019511736
UR - https://www.scopus.com/pages/publications/0019511736#tab=citedBy
U2 - 10.1097/00000542-198109000-00016
DO - 10.1097/00000542-198109000-00016
M3 - Article
AN - SCOPUS:0019511736
SN - 0042-1215
VL - 55
SP - 277
EP - 280
JO - Unknown Journal
JF - Unknown Journal
IS - 3
ER -