Myocardial metabolism and coronary sinus blood flow during coronary artery surgery: effects of nitroprusside and nifedipine. 1987

H B van Wezel, and J G Bovill, and J J Koolen, and G A Barendse, and J W Fiolet, and J P Dijkhuis

The effects of nitroprusside and nifedipine on hemodynamics, coronary dynamics, and global myocardial metabolism were compared in two groups of patients undergoing elective coronary artery surgery, who were anesthetized with fentanyl, 100 micrograms/kg. After induction of anesthesia, either nitroprusside or nifedipine was started as follows: group S (n = 11) received nitroprusside at an initial rate of 1.3 micrograms/kg/min; group N (n = 9) received nifedipine at an initial rate of 0.7 micrograms/kg/min. Infusion rates were adjusted to maintain systolic blood pressure (SBP) between 80% and 120% of preinfusion (control) values. Control measurements were obtained 10 minutes after intubation. Then vasodilator infusion was started. Additional measurements were obtained 10 minutes after the start of infusion (before surgery) and after sternotomy. The mean (+/- SD) total dose requirements were: nitroprusside, 1.6 +/- 0.3 micrograms/kg/min; and nifedipine 1.1 +/- 0.7 micrograms/kg/min. The mean (+/- SD) total infusion time was: nitroprusside, 32 +/- 5 minutes; and nifedipine, 37 +/- 7 minutes. After 10 minutes of infusion there were decreases in SBP (p less than 0.001) and diastolic blood pressure (DBP; p less than 0.01) in group S. In group N only SBP decreased (p less than 0.01). At this time there were no significant changes in coronary sinus blood flow (CSBF) or myocardial oxygen consumption (MVO2) in either group. After stenotomy DBP remained decreased (p less than 0.05) in group S.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009206 Myocardium The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow. Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D009543 Nifedipine A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure. Adalat,BAY-a-1040,Bay-1040,Cordipin,Cordipine,Corinfar,Fenigidin,Korinfar,Nifangin,Nifedipine Monohydrochloride,Nifedipine-GTIS,Procardia,Procardia XL,Vascard,BAY a 1040,BAYa1040,Bay 1040,Bay1040,Monohydrochloride, Nifedipine,Nifedipine GTIS
D009599 Nitroprusside A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins. Nitroferricyanide,Sodium Nitroprusside,Cyanonitrosylferrate,Ketostix,Naniprus,Nipride,Nipruton,Nitriate,Nitropress,Nitroprussiat Fides,Nitroprusside, Disodium Salt,Nitroprusside, Disodium Salt, Dihydrate,Disodium Salt Nitroprusside,Nitroprusside, Sodium
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic

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