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Asian Cardiovasc Thorac Ann 2005;13:302-306
© 2005 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTION

Comparison of Antihypertensives after Coronary Artery Surgery

Fevzi Toraman, MD, Hasan Karabulut, MD1, Onur Goksel, MD2, Serdar Evrenkaya, MD1, Sumer Tarcan, MD1, Cem Alhan, MD1

Department of Cardiovascular Anesthesiology
1 Department of Cardiovascular Surgery Acibadem Hospital
2 Dr Siyami Ersek Thoracic & Cardiovascular Surgery Center Istanbul, Turkey

For reprint information contact: Onur Goksel. MD Tel: 90 532 795 9118 Fax: 90 216 348 0269 Email: onurgoksel{at}hotmail.com, 4. Gazeteciler Sitesi, C3 Blok, Da: 16,1. Levent, 80620 Istanbul, Turkey.

Hypertension following coronary artery bypass grafting is a common problem that may result in postoperative myocardial infraction or bleeding, Hemodynamic effects were compared in 45 hypertensive coronary bypass patients randomized to receive either diltiazem, nitroglycerin, or sodium nitroprusside. Diltiazem was administered as an intravenous bolus of 0.3 mg·kg–1 within 5 min, followed by infusion of 0.1–0.8 mg·kg–1·h–1 in group 1. Nitroglycerin was infused at a rate of 1–3 µg·kg·h–1 in group 2, and sodium nitroprusside was given at a rate of 1–3 µg·kg–1·min–1 in group 3. Hemodynamic measurements were carried out before infusion (T1) and at 30 min (T2), 2 h (T3), and 12 h (T4) after initiation of treatment in the intensive care unit. Mean arterial pressure decreased significantly in all groups. There were no differences among groups at T1 and T2. At T3, heart rate in group 2 was significantly higher than group 1. At T3 and T4, the double product was highest in group 3 (group 1 vs. 3, p < 0.001). These results suggest that the hemodynamic effects of the 3 drugs are similar within the first 30 min. However, after 30 min, diltiazem affords better myocardial performance and more effective control of hypertension.






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