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Canadian Journal of Anesthesia, Vol 30, 142-147, Copyright © 1983 by Canadian Anesthesiologists' Society

A Profile of Intravenous Nitroglycerin use in Cardiopulmonary Bypass Surgery

G. E. TOWNSEND MD FRCP(C)1, J. E. WYNANDS MD FRCP(C)1, D. G. WHALLEY MB CHB FFARCS FRCP(C)1, A. Y. COHEN MD FRCP(C)1, and M. C. BESSETTE RITAT RAT1

1 Department of Anaesthesia, Royal Victoria Hospital, McGill University, Montréal, Québec

Address Correspondence to: Dr. J.E. Wynands, Department of Anaesthesia, Royal Victoria Hospital, 687 Pine Avenue West, Montréal, Québec H3A 1A1.

We studied the indications for use, time to onset of effect, approximate effective concentration and therapeutic success of commercially prepared intravenous nitroglycerin (NTG) in 50 patients undergoing cardiopulmonary bypass (CPB) surgery. Nitroglycerin was used to treat systemic or pulmonary hypertension, myocardial ischaemia and ventricular failure. Twenty-one patients had more than one indication for NTG use. Nineteen of 22 patients with pulmonary hypertension, 12 of 13 patients with ischaemic changes, and 13 of 15 patients with ventricular failure improved during intravenous NTG administration. Hypertension during CPB was ameliorated in only six often instances. The time to onset of effect ranged from 4.1 ± 0.8 to 7.8 ± 2.8 minutes and the mean approximate effective NTG concentration varied from 1.7 ± 0.3 to 2.9 ± 0.7 µg.kg-1.min-1 (doses only approximate due to our use of an infusion system which absorbs NTG). Complications from intravenous NTG administration were not seen. We conclude that this NTG preparation facilitates treatment of prebypass hypertension, pulmonary hypertension, myocardial ischaemia and ventricular failure but is less effective for the treatment of hypertension during CPB.

Key Words: PHARMACOLOGY: nitroglycerin • SURGERY; cardiac • BLOOD PRESSURE: pulmonary hypertension, systemic hypertension






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Copyright © 1983 by the Canadian Anesthesiologists' Society.