Efficiency of proxodolol in treatment of arterial hypertension in cardiac surgery cases

Akselrod B.A.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Guskov D.A.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Vachnadze D.I.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Pshenichniy T.A.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Gubko A.V.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Efficiency of proxodolol in treatment of arterial hypertension in cardiac surgery cases

Authors:

Akselrod B.A., Guskov D.A., Vachnadze D.I., Pshenichniy T.A., Gubko A.V.

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Journal: Russian Journal of Anesthesiology and Reanimatology. 2018;(3): 47‑53

DOI: 10.17116/anaesthesiology201803147

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Akselrod BA, Guskov DA, Vachnadze DI, Pshenichniy TA, Gubko AV. Efficiency of proxodolol in treatment of arterial hypertension in cardiac surgery cases. Russian Journal of Anesthesiology and Reanimatology. 2018;(3):47‑53. (In Russ.)
https://doi.org/10.17116/anaesthesiology201803147

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Elevation of the blood pressure (BP) in cardiac surgery remains a highly challenging issue. High intraoperative BP increases total blood loss, associates with high-risk of myocardial infarction and stroke and results in an increased hospital mortality. Despite having a variety of different hypotensive drugs, no one of them fully meet all efficiency and safety criteria for intraoperative usage. Probably, Proxodolol will become a breath of fresh air in this question. Aim — to evaluate the efficacy and safety (β + α) –adrenoblocking agent Proxodolol in the management of intraoperative arterial hypertension in cardiac surgery patients. Material and methods. We included 33 elective cardiac surgery patients in this study. Patients were separated into two groups: first group with arterial hypertension during spontaneous circulation (n=23) and second group with arterial hypertension during cardiopulmonary bypass (CPB) (n=10). All patients underwent multicomponent balanced anesthesia. We also evaluated the depth of anesthesia. Blood pressure was measured through radial arterial line. We determined systolic BP ≥140 mm Hg (SBP) and diastolic BP ≥90 mm Hg (DBP) as elevated BP in the first group and mean BP ≥90 mm Hg (MBP) in the CPB group. When additional analgesia had not helped, we used Proxodolol 10—20 mg IV bolus. If necessary, we repeated boluses every 3 minutes. The effectiveness criteria was 15% decrease in BP. Results. Proxodolol showed efficiency in 21 (91%) cases in the first group (p<0.05) and 8 (80%) in the second (p<0.05). Mean effective time was 6±2.3 min. In the first group, baseline values were SBP 156 (147—172) mm Hg, DBP 85±13 mm Hg, MBP 105±18 mm Hg. After Proxodolol use blood pressure values decreased: SBP 25.6% (116 (99—140) mm Hg), DBP 24.7% (64±8 mm Hg), MBP 20% (84±11 mm Hg) (p<0.001). In the second group MBP level was 99±4 mm Hg and decreased by 18.2% (81±9 mm Hg (p<0.001)) after Proxodolol administration. In addition, Proxodolol reduces heart rate by 11.6% (p<0.05). Only one episode of bradycardia (42/min) occurred. Conclusion. Proxodolol is safe and effective drug for intraoperative blood pressure control in cardiovascular surgery cases.

Keywords:

intraoperative arterial hypertension; systemic hypertension; hypertension during CPB; Proxodolol

Authors:

Akselrod B.A.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Guskov D.A.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Vachnadze D.I.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Pshenichniy T.A.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

Gubko A.V.

Federal Agency Research Organizations, Federal State Budgetary Scientific Institution «Petrovsky National Research Centre of Surgery», Moscow, Russia

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