The effectiveness of proxodolol in postoperative arterial hypertension management in cardiac surgery patients

Eremenko A.A.; Sorokina L.S.; Kurochkina N.S.

doi:https://doi.org/10.17116/kardio201811239-44

Eremenko A.A.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Sorokina L.S.

Intensive Care Department II of Petrovsky Russian Research Center for Surgery, Moscow, Russia

Kurochkina N.S.

Intensive Care Department II of Petrovsky Russian Research Center for Surgery, Moscow, Russia

The effectiveness of proxodolol in postoperative arterial hypertension management in cardiac surgery patients

Authors:

Eremenko A.A., Sorokina L.S., Kurochkina N.S.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2018;11(2): 39‑44

DOI: 10.17116/kardio201811239-44

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To cite this article:

Eremenko AA, Sorokina LS, Kurochkina NS. The effectiveness of proxodolol in postoperative arterial hypertension management in cardiac surgery patients. Russian Journal of Cardiology and Cardiovascular Surgery. 2018;11(2):39‑44. (In Russ.)
https://doi.org/10.17116/kardio201811239-44

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

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Abstract:

Aim — to evaluate efficacy and safety of (β+α)-adrenoblocker proxodolol for postoperative arterial hypertension (PAH) management in early period after cardiac surgery. Material and methods. The study enrolled 30 patients (45—78 years, mean age was 60.5±7.3 years), who underwent on- and off-pump cardiac procedures. PAH developed within several hours after surgery when all of patients were on mechanical ventilation with RASS sedation score 2—4. All patients had preoperative history of arterial hypertension and received medication. Proxodolol 20 mg was injected intravenously within 1 min. Additional injections were carried out every 5 minutes if it was necessary for adequate therapeutic effect. Maximal dosage was 100 mg. Results. Treatment was effective in 83.4% of cases. The most effective doses were 40 and 60 mg in 20 and 36.9% of cases, respectively. Antihypertensive effect of proxodolol remained during 24 hours after injection. There was mild decrease of heart rate (4—7%) in all cases, that confirmed advisability of proxodolol administration for arterial hypertension without tachycardia. There were no adverse effects that proved proxodolol‘s safety. Conclusion. Proxodolol is safe and effective medicine to control postoperative hypertension after cardiac surgery.

Keywords:

postoperative arterial hypertension

proxodolol

Authors:

Eremenko A.A.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Sorokina L.S.

Intensive Care Department II of Petrovsky Russian Research Center for Surgery, Moscow, Russia

Kurochkina N.S.

Intensive Care Department II of Petrovsky Russian Research Center for Surgery, Moscow, Russia

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References:

Aronson S, Dyke CM, Stierer KA, et al. The ECLIPSE trials: comparative studies of clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine for acute hypertension treatment in cardiac surgery patients. Anesth Analg. 2008;107(4):1110-1121. https://doi.org/10.1161/CIRCULATIONAHA.106.623538
Vuylsteke A, Vincent JL, de La Garanderie DP, et al. Euro-STAT Investigators Characteristics, practice patterns, and outcomes in patients with acute hypertension: European registry for Studing the Treatment of Acute hyper Tension (Euro-STAT). Crit Care. 2011;15(6). https://doi.org/10.1186/cc10551
Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. European Heart Journal. 2009;30:2769-2812.
James MFM, Dyer RA, Rayner BL. A modern look at hypertension and anesthesia. S Afr J Anaesth Analg. 2011;17(2):168-173. https://doi.org/10.1080/16089677.2014.11073601
Yang V, еt al. Therapeutic effects of intravenous urapidil in elderly patients with hypertension and acute decompensated heart failure: A pilot clinical trial. Experement and Therapeutic Med. 2016;115-122. https://doi.org/10.3892/etm.2016.3302
Aronson S, Fontes ML, et al. Risk index for perioperative renal dysfunction/failure: critical dependence on pulse pressure hypertension. Circulation. 2007;115:733-742. https://doi.org/10.1161/CIRCULATIONAHA.106.623538
Manolis AJ, Erdine S, Borghi C, et al. Perioperative screening and management of hypertensive patients. European Society of Hypertension Scientific Newsletter update on hypertension management. 2010;11:47:1133-1137.
Intensivnaya terapiya. Natsional’noe rukovodstvo. Kratkoe izdanie. Pod red. Gel’fanda BR, Zabolotskikh IB. Moscow: GEOTAR-MEDIA. 2017. (In Russ.)
Mancia G, Fagard, еt al. Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281-1357. https://doi.org/10.1097/01.hjh.0000431740.32696.cc
Lonjaret L, Lairez O, Minville V. Optimal perioperative management of arterial blood pressure Integr. Blood Pressure Control. 2014;7:49-59. https://doi.org/10.2147/IBPC.S45292
Lien SF, Bisognano JD. Perioperative hypertension: defining at-risk patients and their management. Curr Hypertens Rep. 2012;14:432-441. https://doi.org/10.1007/s11906-012-0287-2
Howell SJ, Sear JW, Foex P. Hypertension, hypertensive heart disease and perioperative cardiac risk. Br J Anaesth. 2004;92:570-583. https://doi.org/10.1093/bja/aeh091
Goldberg ME, Larijani GE. Perioperative hypertension. Pharmacotherapy. 1998;18:911-914.
Gray RJ, Bateman TM, Czer LS, et al. Comparison of esmolol and nitroprusside for acute post-cardiac surgical hypertension. Am J Cardiol. 1987;59:887-891.
Bebawy JE, Houston CC, Kosky JL, Badri AM, Hemmer LB, et al. Nicardipine is superior to esmolol for the management of postcraniotomy emergence hypertension: a randomized open-label study. 2015;120:186-191. https://doi.org/10.4172/2167-1095.1000202
Eremenko AA, Chernova EV. Lechenie deliriya v rannem posleoperatsionnom periode u kardiokhirurgicheskikh patsientov. Anesteziologiya i reanimatologiya. 2014;3:30-34. (In Russ.)
Naaz S, Ozair E. Dexmedetomidine in current anaesthesia practice — a review. J Clin Diagn Res. 2014;8:GE01-GE04. https://doi.org/10.7860/2FJCDR/2F2014/2F9624.4946
Taittonen MT, Kirvelä OA, Aantaa R, Kanto JH. Effect of clonidine and dexmedetomidine premedication on perioperative oxygen consumption and haemodynamic state. Br J Anaesth. 1997;78:400-406. https://doi.org/10.1093/bja/78.4.400
van der Stroom JG, van Wezel HB, Langemeijer JJ, et al. A randomized multicenter double-blind comparison of urapidil and ketanserin in hypertensive patients after coronary artery surgery. J Cardiothorac Vasc Anesth. 1997;11(6):729-736. https://doi.org/10.2147/IBPC.S45292
Eremenko AA, Zyulyaeva TP. Gemodinamicheskie effekty Lomira i Adalata u bol’nykh s posleoperatsionnoi arterial’noi gipertenziei. Anesteziologiya i reanimatologiya. 1999;5:63-66. (In Russ.)
Wilson DJ, Wallin JD, Vlachakis ND, Freis ED, Vidt DG, et al. Intravenous labetalol in the treatment of hypertension and hypertensive emergencies. Am J Med. 1988;62:1062-1067.
Leonova MV. Mesto novogo otechestvennogo α-β-adrenoblokatora proksodolola v lechenii gipertonicheskogo kriza. Rossiiskii kardiologicheskii zhurnal. 2002;5:66-68. (In Russ.)
Tereshchenko SN, Abdrakhmanov VR, Gaponova NI, et al. Otkrytoe randomizirovannoe mnogotsentrovoe sravnitel’noe issledovanie effektivnosti i bezopasnosti preparata AL’BETOR i enalaprilat u bol’nykh s neoslozhnennym gipertonicheskim krizom (ALBATROS). Sistemnye gipertenzii. 2010;4:38-41. (In Russ.)
Gaponova NI, Baratashvili VL, Tereshchenko SN. Stantsiya skoroi i neotlozhnoi meditsinskoi pomoshchi im. A.S. Puchkova Moskvy; GOU MGMSU Minzdravsotsrazvitiya Rossii; FGU RKNPK Rosmedtekhnologii. Effektivnayа farmakoterapiyа. Kardiologiya i Angiologiya. 2011;3:54-59. (In Russ.)