Urapidil was administered in 69 patients aged between 46-79 age (average 62.7 +/- 8.4 age) to control intra-operative increase in arterial blood pressure accompanying endotracheal intubation, extubation, wakening of the patients, incision of abdominal integument and clamping of abdominal aorta. In presented group 47 patients suffered from arterial
hypertension and 22 patients did not. Patients underwent various
surgical procedures in
general anesthesia and in 13 patients implantation of aortal
prosthesis in result of
abdominal aortic aneurysm (7 patients) and
Leriche syndrome (5 patients) was performed.
RESULTS:
Urapidil turned out to be efficacious in 56 patients (81.1%), in 40 patients with previously diagnosed arterial
hypertension and 16 patients who did not suffer from
hypertension. In 13 other patients (18.9%) monotherapy with
urapidil brought a desired hemodynamic effect and infusion of nitroglycerine was necessary. In a group of patients receiving
urapidil during monotherapy, the average dosage of the medicine required to lower arterial blood pressure amounted to 26.3 +/- 2.4 mg, and respectively in patients with arterial
hypertension 30.5 +/- 3.5 mg, and in patients without arterial
hypertension to 22.1 +/- 4.5 mg and desired reduction of pressure was obtained on average after 11.2 +/- 3.4 minutes. Reduction of systolic pressure amounted on average to 30.5 +/- 13.5 mmHg (4.0 +/- 1.4 kPa) whereas diastolic pressure to 15.5 +/- 7.5 mmHg (2.0 +/- 1.0 kPa). In 13 patients subject to the administration of 83.7 +/- 6.5 mg of
urapidil, on average desired effected was not achieved and it was necessary to infuse
nitroglycerin. Among these patients reduction of systolic (average 35.3 +/- 10.7 mmHg/4.7 +/- 1.4 kPa) and diastolic pressure (average 16.7 +/- 8.3 mmHg/2.2 +/- 1.1 kPa) was obtained after 16.3 +/- 5.1 minutes on average. In patients receiving
urapidil during monotherapy no acceleration of heart beat per minute was observed. On the other hand significant increase (p < 0.05) by 16.8 +/- 8.2 per minute was registered in patients receiving
urapidil with nitroglycerine and it was significantly higher (p < 0.05) in patients not suffering from arterial
hypertension. None of the patients suffered from
arrhythmia. In 2 patients undergoing operation complications occurred within the area of abdominal aorta as
ischemia of myocardium.
CONCLUSIONS:
Urapidil administered during monotherapy turned out to be efficacious in 81.1% of treated patients. Other 18.9% required an additional infusion of nitroglycerine, but these were patients operated on due to abdominal aorta. Average dosage of
urapidil applied during monotherapy amounted to 26.3 +/- 2.4 mg. Intraoperative administration of
urapidil did not result in acceleration of heart rate, and
urapidil turned out to be a safe medicine to reduce intraoperative increase in arterial blood pressure also in patients who were previously diagnosed as suffering from arterial
hypertension.