The American Journal of Digestive Diseases

, Volume 16, Issue 6, pp 517–521 | Cite as

Reduction of portal hypertension by ganglionic blockade

  • John Cincotti
  • Richard Huemer
Article
  • 13 Downloads

Abstract

The effect of the ganglionic blocking agent, trimethaphan camsylate, on the portal venous and systemic arterial blood pressure was evaluated in 58 cirrhotic patients who had esophageal varices secondary to portal hypertension. Portal venous pressure was monitored by splenic-pulp manometry. Trimethaphan induced a mean decrease of 31.0% in portal pressure and 39.3% in arterial pressure. Both decrements were highly significant (P<0.005). Pressure decrements generally were greater in those patients whose initial pressure readings were higher. Reduced levels of portal and arterial blood pressure were maintained throughout the period of drug infusion.

Keywords

Arterial Pressure Arterial Blood Pressure Portal Hypertension Venous Pressure Cirrhotic Patient 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Cincotti J, Welch H, Carter J, et al: Reduction of portal hypertension by nonshunting methods in patients with cirrhosis. Surg Forum 11:276–277, 1960PubMedGoogle Scholar
  2. 2.
    Butz GW Jr, Lazarus RE, Schiller WR, et al: Studies of the effects and modes of action of autonomic drugs on portal hemodynamics. Surgery 51:364–369, 1962PubMedGoogle Scholar
  3. 3.
    Kuhn T, Joseph WL, Cincotti JJ: Ganglionic blocking agents as a method of avoiding emergency portal decompression. Surg Forum 18:394–395, 1967Google Scholar
  4. 4.
    Hopkins RW, Fratianne R, Penn I, et al: Controlled hypotension in the management of severe hemorrhage. Ann Surg 160:669–680, 1964PubMedGoogle Scholar
  5. 5.
    Merritt JA: Complications related to blood replacement. Amer J Surg 116:333–336, 1968PubMedGoogle Scholar
  6. 6.
    Kehne JH, Hughes FA, Gompertz ML: The use of surgical Pituitrin in the control of esophageal varix bleeding. Surgery 39:917–925, 1956PubMedGoogle Scholar
  7. 7.
    Davis WD Jr, Gorlin R, Reichman S, et al: Effect of Pituitrin in reducing portal pressure in the human being. New Eng J Med 256:108–111, 1957PubMedGoogle Scholar
  8. 8.
    Schwartz SI, Bales HW, Emerson GL, et al: The use of intravenous Pituitrin in the treatment of bleeding esophageal varices. Surgery 45:72–79, 1959PubMedGoogle Scholar
  9. 9.
    Shaldon S, Sherlock S: The use of vasopressin (“Pitressin”) in the control of bleeding from oesophageal varices. Lancet II:222–225, 1960Google Scholar
  10. 10.
    Kessler RE: Effects of vasopressin on portal vein pressure in the unanesthetized man. Surg Forum 19:335–337, 1968PubMedGoogle Scholar
  11. 11.
    Tsakiris A, Haemmerli UP, Bühlmann A: Reduction of portal venous pressure in cirrhotic patients with bleeding from oesophageal varices, by administration of a vasopressin derivative, phenylalanine2-lysine8-vasopressin. Amer J Med 36:825–839, 1964PubMedGoogle Scholar
  12. 12.
    Nusbaum M, Baum S, Sakiyalak P, et al: Pharmacologic control of portal hypertension. Surgery 62:299–310, 1967Google Scholar
  13. 13.
    Little DM Jr: Induced hypotension during anesthesia and surgery. Anesthesiology 16:320–332, 1955PubMedGoogle Scholar
  14. 14.
    Wheat MW Jr, Palmer RF, Bartley TD, et al: Treatment of dissecting aneurysms of the aorta without surgery. J Thorac Cardiovasc Surg 50:364–371, 1965PubMedGoogle Scholar
  15. 15.
    Cook WA, Schwartz DL, Bass BG: Arfonad therapy: hemodynamic responses and control. Ann Thorac Surg 7:322–332, 1969PubMedGoogle Scholar
  16. 16.
    Converse JG, McKechnie FB, Boba A: Arfonad in hemorrhage. New York J Med 57:731–739, 1957PubMedGoogle Scholar
  17. 17.
    Kaplan A, Davies JI, Heilbrunn A: The experimental use of controlled portal and systemic hypotension for liver resection. Surgery 62:325–332, 1967Google Scholar
  18. 18.
    Shaftan GW, Chiu C-J, Dennis C, et al: Fundamentals of physiologic control of arterial hemorrhage. Surgery 58:851–856, 1965PubMedGoogle Scholar
  19. 19.
    Shaftan GW, Asrani UF, Enker WE, et al: Hypervolemia during ganglionic blockade hypotension. Surgery 65:321–331, 1969PubMedGoogle Scholar
  20. 20.
    Cincotti J, Meacham EJ: Unpublished dataGoogle Scholar

Copyright information

© Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1971

Authors and Affiliations

  • John Cincotti
    • 1
  • Richard Huemer
    • 1
  1. 1.From the Surgery Service and Research ServiceVeterans Administration HospitalSepulveda

Personalised recommendations