Hatano Y, Mori K, Yoshiya I, Miyazaki M, Fujimori M, Amakata Y, Hyodo M, Uchida M, Okuda T, Ishida H
Department of Anesthesiology, Wakayama Medical College.
Masui. 1991 Nov;40(11):1705-14.
The antihypertensive effect of intravenous injection of isosorbide dinitrate (ISDN) was evaluated in 137 patients undergoing elective surgery during general anesthesia [neuroleptanesthesia (NLA) or enflurane-nitrous oxide-oxygen-anesthesia (GOE)]. ISDN in dose of 20 micrograms.kg-1 or 40 micrograms.kg-1 was given as a bolus injection in 30 sec. ISDN produced a significant decrease in arterial pressure and central venous pressure; the maximum decrease was observed in 7 min after administration of ISDN. The antihypertensive effect of ISDN was dose-dependent, but there was no significant difference between two groups of patients given 20 or 40 micrograms.kg-1, or between those anesthetized with NLA or GOE. ISDN did not significantly alter heart rate, thereby causing a significant decrease in rate pressure product which reflects myocardial oxygen demand. The results suggest that a bolus injection of ISDN is a simple, practical and effective means of controlling hypertension during general anesthesia.