Labetalol in Controlled Hypotension

Cope, D. H. P.; Crawford, M.

doi:10.1093/bja/51.4.359

Cited by 29 publications

(4 citation statements)

References 15 publications

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“…Continuous ECG monitoring revealed no adverse changes in any of these ischaemic hearts, and there were no post-operative sequelae (Cope & Crawford, 1979). Reversal of the hypotension in all cases was readily achieved by the intravenous administration of atropine sulphate 0.6 mg, systolic BP rapidly returning to a near normal level.…”

Section: Resultsmentioning

confidence: 74%

Use of labetalol during halothane anaesthesia.

Cope¹

1979

Brit J Clinical Pharma

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1 The drugs that are available to attain controlled hypotension during anaesthesia are not entirely satisfactory. 2 Problems in controlling hypotension are encountered in the young, the anxious, patients with a tachycardia, and in those for whom halothane is contra-indicated. 3 Labetalol has been investigated as an adjunct to controlled hypotension in 150 major surgical procedures. Anaesthetic technique, labetalol dosage and results are discussed. 4 Labetalol in patients under halothane anaesthesia resulted in a rapid attainment of hypotension which was easily controlled, and quickly and permanently reversed by the intravenous administration of atropine sulphate. It was especially useful in patients in whom problems with other techniques can be anticipated. 5 Controlled hypotension with labetalol was also used in patients with ischaemic heart disease with good cardiovascular control and without any untoward effects.

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Section: Resultsmentioning

confidence: 74%

Use of labetalol during halothane anaesthesia.

Cope¹

1979

Brit J Clinical Pharma

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“…One must be cautious in applying the results of our study to man. The doses of labetalol needed to establish arterial hypotension in dogs anaesthetized with pentobarbitone and fentanyl were much larger than those used in earlier studies in man (Scott et al, 1978;Cope and Crawford, 1979). In spite of these high doses, however, haemodynamic changes were minimal and perfusion was well maintained.…”

Section: Table II Fractional Distribution Of Cardiac Output and Indimentioning

confidence: 74%

“…Labetalol (Glaxo Laboratories) possesses both alpha-and beta-adrenergic blocking properties (Farmer et al, 1972). Its use in hypotensive anaesthesia has been reported by Scon and others (1978) and Cope and Crawford (1979) who obtained a satisfactory decrease in arterial pressure unaccompanied by tachycardia in patients anaesthetized with halothane. Changes in regional blood flow during deliberate hypotension with labetalol have not been reported.…”

mentioning

confidence: 87%

Haemodynamic Effects of Labetalol-Induced Hypotension in the Anaesthetized Dog

Gustafson

Ahlgren

Aronsen

et al. 1981

British Journal of Anaesthesia

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Central haemodynamic changes and regional blood flow were studied using the microsphere technique, during labetalol-induced hypotension in dogs anaesthetized with pentobarbitone and fentanyl. Labetalol 15 mg kg-1 decreased mean arterial pressure from an average of 88 mm Hg to 47 mm Hg. Mean pulmonary arterial pressure was unchanged. Cardiac output was reduced by decrease in stroke volume, while heart rate remained unchanged. Myocardial blood flow decreased approximately in parallel with left ventricular work. Perfusion of the brain and kidneys was unchanged.

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“…As nitroprusside is not devoid of adverse effects such as tachycardia, tachyphylaxis, increased intrapulmonary shunt (3), and cyanide toxicity (4), the search for other useful agents has continued. Labetalol, an aand Padrenergic blocking agent, in combination with various inhalation anesthetics, has been advocated for the induction of hypotension (5)(6)(7)(8)(9). Although it has been suggested that labetalol, when used to produce deliberate hypotension, may not increase intrapulmonary shunting, there is insufficient evidence to support this.…”

Section: Pharmacology Nitroprussidementioning

confidence: 99%

A Comparison of Labetalol and Nitroprusside for Inducing Hypotension During Major Surgery

Goldberg

McNulty²,

Azad³

et al. 1990

Anesthesia & Analgesia

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The hemodynamic and intrapulmonary shunt effects of intravenous labetalol and nitroprusside were compared during induced hypotension for major spinal surgery. A randomized, double-blind protocol was used in which 20 patients, ASA physical status I or II, received either nitroprusside infusion (n = 10) or labetalol bolus injections of 10 mg every 10 min (n = 10) until mean arterial blood pressure was reduced to 55-60 mm Hg. Pulmonary artery pressures were measured and mixed venous samples obtained via a pulmonary artery catheter. Nitroprusside increased heart rate significantly more than labetalol during the period of hypotension. When compared with prehypotension baseline values, nitroprusside increased heart rate significantly with a concomitant significant decrease in systemic vascular resistance. Cardiac output increased significantly 60 min after hypotension was achieved in patients treated with nitroprusside. Systemic vascular resistance decreased significantly below baseline levels in patients treated with labetalol but without changes in cardiac output, heart rate, or mean pulmonary artery pressure. There was a 122% increase in intrapulmonary shunt with nitroprusside administration, compared with an 11% increase with labetalol. Labetalol was effective for inducing hypotension and was not associated with an increase in heart rate, intrapulmonary shunt, or cardiac output as seen with nitroprusside.

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Labetalol in Controlled Hypotension

Cited by 29 publications

References 15 publications

Use of labetalol during halothane anaesthesia.

Use of labetalol during halothane anaesthesia.

Haemodynamic Effects of Labetalol-Induced Hypotension in the Anaesthetized Dog

A Comparison of Labetalol and Nitroprusside for Inducing Hypotension During Major Surgery

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