Intra-operative blood pressure control by prostaglandin E1 in patients with hypertension and ischemic heart disease - A multi-center study

Sumio Hoka, Junichi Yoshitake, Kenjiro Dan, Yutaka Goto, Natsuo Honda, Tohru Morioka, Takesuke Muteki, Yoshiro Okuda, Akio Shigematsu, Mayumi Takasaki, Tadahide Totoki, Nozomu Yoshimura

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Abstract

The purpose of this multi-center study was to evaluate the efficacy and safety of prostaglandin E1 (PGE1) administration in achieving deliberate hypotension and in treating intraoperative hypertension for patients with a history of hypertension and ischemic heart disease. PGE1 (0.08 μg·kg-1·min-1) decreased systolic blood pressure from 125±29 to 106±22 mmHg (mean±SD) in the deliberate hypotension group (n=158) and from 155±34 to 125±32 mmHg in the antihypertension group (n=55). The heart rate significantly increased from 80±15 to 85±18 beatsomin-1 in the deliberate hypotension group, but was not significantly altered in the antihypertension group. The time required to obtain the desired level of blood pressure was approximately 20 min in the deliberate hypotension group. When the infusion was stopped, blood pressure returned approximately to the preinfusion level within about 20 min. No rebound hypertension was observed. PGE1 significantly increased the urine flow in patients who had a low urine flow before PGE1 infusion. Thirteen out of 213 patients (5.6%) had side effects such as excessive hypotension (1%), phlebitis (3%), and unexpected tachycardia (1 %), which were alleviated gradually after discontinuation of PGEI infusion. No dysarrhythmia and further ST segment changes in the electrocardiograms were observed. These findings suggest that PGE1 can be safely used to control arterial blood pressure during surgery in patients having preoperative hypertension and ischemic heart disease.

Original languageEnglish
Pages (from-to)173-183
Number of pages11
JournalJournal of Anesthesia
Volume7
Issue number2
DOIs
Publication statusPublished - Apr 1 1993

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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    Hoka, S., Yoshitake, J., Dan, K., Goto, Y., Honda, N., Morioka, T., Muteki, T., Okuda, Y., Shigematsu, A., Takasaki, M., Totoki, T., & Yoshimura, N. (1993). Intra-operative blood pressure control by prostaglandin E1 in patients with hypertension and ischemic heart disease - A multi-center study. Journal of Anesthesia, 7(2), 173-183. https://doi.org/10.1007/s0054030070173