Tannières M L, Chelly J, Derome P, Visot A, Vourc'h P
Anesth Analg (Paris). 1979 Mar-Apr;36(3-4):139-45.
Nitroglycerine has a direct vasodilating action on both venous and arterial smooth muscle fibers. On account of this, it has been used as hypotensive agent, in aqueous solution, on 22 surgical patients, 10 of them in neurosurgery. The total doses used were 0.76 +/- 0.12 mg/kg during 94 +/- 30 minutes (rate = 8.1 microgram/kg/min). Nitroglycerine induces a rapid onset of hypotension (3 to 4 min), spontaneously reversible in 27 +/- 8 minutes after the arrest of the infusion. The mean drop in mean arterial blood pressure achieved has been 34 p. cent. It is accompanied by a 67 +/- 9 p. cent fall of filling pressures and a fall 13 +/- 4 p. cent of cardiac index, without modification of the heart rate. Tachyphylaxis was noted 15 +/- 6 minutes following nitroglycerine infusion at rate lower than 2 microgram/kg/min, but not when the rate was above 10 microgram/kg/min. Therefore, if the drug is used to achieve controlled hypotension, high doses are necessary. No signs of toxicity were noted. In 4 cases, other hypotensive agents had been used to bring the mean arterial blood pressure below 50 Torr, which could not be achieved with nitroglycerine alone.
硝酸甘油对静脉和动脉平滑肌纤维均有直接的血管舒张作用。基于此，它已被用作降压药，以水溶液形式应用于22例外科手术患者，其中10例为神经外科手术患者。在94±30分钟内（速率 = 8.1微克/千克/分钟）使用的总剂量为0.76±0.12毫克/千克。硝酸甘油可迅速引发低血压（3至4分钟），在停止输注后27±8分钟内可自行恢复。平均动脉血压的平均降幅达34%。同时，充盈压下降67±9%，心脏指数下降13±4%，而心率无变化。当以低于2微克/千克/分钟的速率输注硝酸甘油时，15±6分钟后会出现快速耐受性，但当速率高于10微克/千克/分钟时则不会出现。因此，如果使用该药物来实现控制性低血压，需要高剂量。未观察到毒性迹象。在4例患者中，曾使用其他降压药将平均动脉血压降至50托以下，仅使用硝酸甘油无法达到这一水平。
