Csongrady A, Mayr E, Kamp H D, Volkholz H J
Anaesthesist. 1979 Dec;28(12):564-71.
During a study of 130 patients undergoing hypotensive anaesthesia for oto-rhino-laryngological surgery the most important dose problems with sodium nitroprusside (S.N.P.) were characterized. In 14% of the cases more than 15 mcg/kg body weight/min S.N.P. were required. Our data show, that the smallest S.N.P. consumption occurs during neuroleptanalgesia in combination with 0.3--0.8 Vol-% enflurane. On the other hand, during neuroleptanalgesia alone, in several cases toxic amounts of S.N.P. would have been necessary to produce adequate hypotension. In such cases about 0.5 mg/kg body weight dihydralazine must be employed as a supporting agent for hypotension. The influence of this drug on the manoeuvrability of the low pressure state and on the administration of S.N.P. was investigated. Although, the equivalent amount of sodium thiosulfate (S.T.) did not increase the S.N.P. sensibility, its routine use is reconviended, since the combination of S.Th, and even higher doses of S.N.P. were tolerated without metabolic acidosis. As an alternative substance after long-term use of S.N.P. nitroglycerine should be used.
在一项对130例接受耳鼻喉科手术低血压麻醉患者的研究中，确定了硝普钠（S.N.P.）最重要的剂量问题。在14%的病例中，需要超过15微克/千克体重/分钟的硝普钠。我们的数据表明，在神经安定镇痛联合0.3 - 0.8体积%安氟醚时，硝普钠的消耗量最小。另一方面，仅在神经安定镇痛期间，在一些病例中，为了产生足够的低血压，需要使用有毒剂量的硝普钠。在这种情况下，必须使用约0.5毫克/千克体重的双肼屈嗪作为低血压的辅助药物。研究了这种药物对低压状态可操作性和硝普钠给药的影响。虽然等量的硫代硫酸钠（S.T.）并没有增加硝普钠的敏感性，但建议常规使用，因为硫代硫酸钠与更高剂量的硝普钠联合使用时可耐受且无代谢性酸中毒。长期使用硝普钠后，应使用硝酸甘油作为替代药物。
