Townsend G E, Wynands J E, Whalley D G, Cohen A Y, Bessette M C
Can Anaesth Soc J. 1983 Mar;30(2):142-7. doi: 10.1007/BF03009343.
We studied the indications for use, time to onset of effect, approximate effective concentration and therapeutic success of commercially prepared intravenous nitroglycerin (NTG) in 50 patients undergoing cardiopulmonary bypass (CPB) surgery. Nitroglycerin was used to treat systemic or pulmonary hypertension, myocardial ischaemia and ventricular failure. Twenty-one patients had more than one indication for NTG use. Nineteen of 22 patients with pulmonary hypertension, 12 of 13 patients with ischaemic changes, and 13 of 15 patients with ventricular failure improved during intravenous NTG administration. Hypertension during CPB was ameliorated in only six of ten instances. The time to onset of effect ranged from 4.1 +/- 0.8 to 7.8 +/- 2.8 minutes and the mean approximate effective NTG concentration varied from 1.7 +/- 0.3 to 2.9 +/- 0.7 micrograms . kg-1.min-1 (doses only approximate due to our use of an infusion system which absorbs NTG). Complications from intravenous NTG administration were not seen. We conclude that this NTG preparation facilitates treatment of prebypass hypertension, pulmonary hypertension, myocardial ischaemia and ventricular failure but is less effective for the treatment of hypertension during CPB.
我们研究了市售静脉注射硝酸甘油（NTG）在50例接受体外循环（CPB）手术患者中的使用指征、起效时间、近似有效浓度及治疗成功率。硝酸甘油用于治疗系统性或肺动脉高压、心肌缺血及心室衰竭。21例患者有不止一项使用硝酸甘油的指征。在静脉注射硝酸甘油期间，22例肺动脉高压患者中的19例、13例有缺血改变患者中的12例以及15例心室衰竭患者中的13例病情改善。CPB期间的高血压仅在10例中的6例得到改善。起效时间为4.1±0.8至7.8±2.8分钟，平均近似有效硝酸甘油浓度在1.7±0.3至2.9±0.7微克·kg⁻¹·min⁻¹之间（由于我们使用的输液系统会吸收硝酸甘油，剂量仅为近似值）。未观察到静脉注射硝酸甘油的并发症。我们得出结论，这种硝酸甘油制剂有助于治疗体外循环前的高血压、肺动脉高压、心肌缺血及心室衰竭，但对CPB期间高血压的治疗效果较差。
