Rebound Arterial Hypertension Following Discontinuation of Sodium Nitroprusside:Aetiology and Prevention
Adverse hemodynamic reactions are known to occur after abrupt withdrawal of cardiovascular drugs (Gerber and Nies, 1979). We and others (Khambata et al., 1979; Packer et al., 1979) have observed that the cessation of sodium nitroprusside (SNP) infusion was followed by an increase in arterial blood pressure. This rebound hypertension can be hazardous when nitroprusside is employed to decrease preload and afterload in patients with severe chronic heart failure or to control arterial pressure for repair of cerebral aneurysms or other vascular lesions. The renin-angiotension system is involved in this phenomenon. The present study was designed (1) to characterize the changes in hemodynamics, plasma catecholamines and plasma renin activity that follow the abrupt cessation of nitroprusside infusion for controlled intraoperative hypotension and (2) to determine the effects of pretreatment with intravenous propranolol on these nitroprusside-induced changes.
KeywordsDopamine Angiotensin Sponge Cyanide Epinephrine
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