Efficacy and safety of oral propranolol premedication to reduce reflex
tachycardia during hypotensive anesthesia with sodium nitroprusside in
orthognathic surgery: a double-blind randomized clinical trial.
Author(s): Apipan B, Rummasak D.
Affiliation(s): Department of Surgery, Mahidol University Faculty of Dentistry, Bangkok,
Thailand. dtbap@mahidol.ac.th
Publication date & source: 2010, J Oral Maxillofac Surg. , 68(1):120-4
PURPOSE: The present study sought to determine whether premedication with oral
propranolol 10 mg before hypotensive anesthesia with sodium nitroprusside could
reduce reflex tachycardia, the amount of sodium nitroprusside used, and blood
loss during hypotensive anesthesia for orthognathic surgery.
PATIENTS AND METHODS: A total of 60 patients undergoing bimaxillary surgery were
studied in a prospective, randomized, and double-blind study of oral propranolol
10 mg or placebo as premedication before hypotensive anesthesia with sodium
nitroprusside. Hemodynamic variables, the amount of sodium nitroprusside used,
and blood loss were statistically analyzed.
RESULTS: The heart rate and amount of sodium nitroprusside used were highly
significantly less (P < .01) in the propranolol group, but no significant
difference was found in blood loss between the 2 groups. No clinically
significant complications were observed in either group.
CONCLUSION: Premedication with oral propranolol 10 mg before hypotensive
anesthesia with sodium nitroprusside is safe and effective to reduce reflex
tachycardia and the amount of sodium nitroprusside used.
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