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Treatment of hypertension with labetalol in neurosurgical practice

Influence of labetalol on cerebral perfusion pressure in dogs without and with intracranial mass lesions

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Summary

In neurosurgical patients autoregulation of cerebral perfusion is often lost. Therefore, a sudden increase in blood pressure may lead to an increase in cerebral blood flow cerebral oedema may follow. The influence of labetalol, a new alpha- and beta-adrenoceptor blocking agent, on intracranial pressure and cerebral perfusion pressure was investigated in dogs without and with mass lesions. During hypotension with labetalol the intracranial pressure remained unchanged and the cerebral perfusion pressure decreased to the same extent as mean arterial pressure (30%). Labetalol seems to be suitable to treat hypertension perioperatively in neurosurgical patients but it is not a suitable drug for induced hypotension.

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References

  1. Bedford, R. F., Winn, H. R., Tyson, G., Pork, T. S., Jane, J. A., Lidocaine prevents increased ICP after endotracheal intubation. In: Intracranial pressure IV (Skulman, R., Marmarou, A., Miller, J. D., Becker, D. P., Hochwald, G. M., Brock, M., eds.), p. 595. Berlin-Heidelberg-New York: Springer. 1980.

    Google Scholar 

  2. Brittain, R. T., Levy, G. P., A review of the animal pharmacology of labetalol, a combined α- and Β-adrenoceptor-blocking drug. Brit. J. Clin. Pharmacol.3 (4) (1976), 681–694.

    Google Scholar 

  3. Cope, D. H. P., Crawford, M. C., Labetalol in controlled hypotension. Brit. J. Anaesth.51 (1979), 359–365.

    PubMed  Google Scholar 

  4. Cottrell, J. E., Patel, K., Turndorf, H., Ransohoff, J., Intracranial pressure changes induced by sodium nitroprusside in patients with intracranial mass lesions. J. Neurosurg.48 (1978), 329–331.

    PubMed  Google Scholar 

  5. Cottrell, J. E., Gupta, B., Turndorf, H., Induced hypotension. In: Anaesthesia and neurosurgery (Cottrell, J. E., Turndorf, H., eds.), p. 387. St. Louis: The C.V. Mosby Comp. 1980.

    Google Scholar 

  6. Cottrell, J. E., Gupta, B., Rappaport, H., Flamm, E., Intracranial pressure during nitroglycerin induced hypotension. J. Neurosurg.53 (1980), 309–312.

    PubMed  Google Scholar 

  7. De Bros, F. M., Zervas, N. T., Propranolol decreases vasodilator induced intracranial hypertension. Anesthesiology53 (Suppl.) (1980), 3.

    PubMed  Google Scholar 

  8. Endo, H., Larsen, B., Lassen, N. A., Regional cerebral blood flow alterations remote from the site of intracranial tumors. J. Neurosurg.46 (1977), 271–281.

    PubMed  Google Scholar 

  9. Fieschi, C., Agnoli, A., Battistini, N., Derangement of regional cerebral blood flow and its regulatory mechanisms in acute cerebrovascular disease. Neurology18 (1968), 1166–1171.

    PubMed  Google Scholar 

  10. Gagnon, R. L., Shapiro, H. M., The effect of diazoxide on intracranial pressure in cats with intracranial mass lesions. Anesthesiology53 (Suppl.) (1980), 200.

    Google Scholar 

  11. Giffin, J. P., Thantum, E., Shwiry, B., Cottrell, J. E., Effects of phentolamine on intracranial pressure. Anesthesiology55 A (1981), 234.

    Google Scholar 

  12. Gupta, B., Cottrell, J. E., Nitroprusside and nitroglycerin induced intracranial pressure changes. In: Intracranial pressure IV (Shulmann, K., Marmarou, A., Miller, J. D., Becker, D. P., Hochwald, G. M., Brock, M., eds.), p. 613. Berlin-Heidelberg-New York: Springer. 1980.

    Google Scholar 

  13. Hoff, J. T., Sengupta, D., Harper, M., Jenett, B., Effect of alpha-adrenergic blockade on response of cerebral circulation of hypocapnia in the baboon. Lancet2 (1972), 1337–1339.

    PubMed  Google Scholar 

  14. Hulme, A., Cooper, R., Changes in intracranial pressure and other variables during the induction of general anaesthesia. Proc. R. Soc. Med.65 (1972), 883–887.

    PubMed  Google Scholar 

  15. Jenett, W. B., McDowall, D. G., Barker, J., The effect of halothane on intracranial pressure in cerebral tumors; report of two cases. J. Neurosurg.26 (1967), 270–274.

    PubMed  Google Scholar 

  16. Jenett, W. B., Barker, J., Fitch, W., McDowall, D. G., Effect of anesthesia on intracranial pressure in patients with space-occupying lesions. Lancet1 (1969), 61–68.

    PubMed  Google Scholar 

  17. Kaasik, A. E., Nilsson, L., Siesjö, B. K., The effect of arterial hypotension upon lactate, pyruvate and bicarbonate concentrations of brain tissue and cisternal CSF, and upon the tissue concentrations of phosphocreatine and adenine nucleotides in anaesthetized rats. Acta Physiol. Scand.78 (1970), 448–458.

    PubMed  Google Scholar 

  18. Kaufman, L., Use of labetalol during hypotensive anaesthesia and in the management of phaeochromocytoma. Brit. J. Clin. Pharmacol.8 (1979), 229–232.

    Google Scholar 

  19. Lassen, M. A., Tweed, W. A., A basis and practice of neuroanesthesia. In: A basis and practice of neuroanesthesia. Monographs in anaesthesiology, Vol. 2 (Gordon, E., ed.), p. 126. New York: Excerpta Medica. 1975.

    Google Scholar 

  20. Leech, P., Barker, J., Fitch, W., Changes in intracranial pressure and systemic arterial pressure during the termination of anaesthesia. Brit. J. Anaesth.46 (1974), 315–316.

    Google Scholar 

  21. Olesen, J., SkinhØj, E., Effects of ergot alkaloids (Hydergine) on cerebral haemodynamics in man. Acta Pharmacol. Toxicol. (Copenhagen)31 (1972), 75–85.

    Google Scholar 

  22. Overgaard, J., SkinhØj, E., The effect of hydralazine on intracranial pressure and cerebral blood flow. In: Blood flow and metabolism of the brain (Harper, A. M.,et al., eds.), pp. 11, 16. Edinburgh-London-New York: Churchill Livingstone. 1975.

    Google Scholar 

  23. Palvölgyi, R., Regional cerebral blood flow in patients with intracranial tumors. J. Neurosurg.31 (1969), 149–163.

    PubMed  Google Scholar 

  24. Pickerodt, V. W. A., Recent aspects of hypotensive drug effects on intracranial pressure. Abstract Symp. on Controlled Hypotension in Neuroanaesthesia. Tübingen, 28. September 1981.

  25. Plum, F., Posner, J. B., Troy, B., Cerebral metabolic and circulatory responses to induced convulsions in animals. Arch. Neurol.18 (1968), 1–6.

    PubMed  Google Scholar 

  26. Richards, D. A., Prichard, B. N. C., Clinical pharmacology of labetalol. Brit. J. Clin. Pharmacol.8 Suppl. (1979), 89–93.

    Google Scholar 

  27. Shapiro, H. M., Wyte, S. R., Harris, A. B., Galindo, A., Acute intraoperative intracranial hypertension in neurosurgical patients: mechanical and pharmacologic factors. Anesthesiology37 (1972), 399–406.

    PubMed  Google Scholar 

  28. Siesjö, B. K., Zwetnow, N. N., The effect of hypovolemic hypotension on extra-and intracellular acid-base parameters and energy metabolites in the rat brain. Acta Physiol. Scan.79 (1970), 114–119.

    Google Scholar 

  29. SkinhØj, E., The sympathetic nervous system and the regulation of cerebral blood flow in man. Stroke3 (1972), 711–715.

    PubMed  Google Scholar 

  30. SkinhØj, E., Strandgaard, S., Pathogenesis of hypertensive encephalopathy. Lancet1 (1973), 461–462.

    PubMed  Google Scholar 

  31. Stoelting, R. K., Circulatory changes during laryngoscopy and endotracheal intubation. Anesthesiology47 (1977), 381–386.

    PubMed  Google Scholar 

  32. Strandgaard, S., MacKenzie, E. T., Sengupta, D., Upper limit of autoregulation of cerebral blood flow in the baboon. Circ. Res.34 (1974), 435–440.

    PubMed  Google Scholar 

  33. Turner, J. M., Powell, D., Gibson, R. M., Intracranial pressure changes in neurosurgical patients during hypotension induced with sodium nitroprusside or trimethaphan. Brit. J. Anaesth.49 (1977), 419–425.

    PubMed  Google Scholar 

  34. Van Aken, H., Puchstein, Ch., Hidding, J., The prevention of hypertension at intubation. Correspondence. Anaesthesia37 (1982), 82–83.

    PubMed  Google Scholar 

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Author notes

  1. C. Puchstein

    Present address: University Clinic of Anaesthesiology and Operative Intensive Care, Westfalian Wilhelms University, Münster, Federal Republic of Germany

Authors and Affiliations

  1. University Clinic of Anaesthesiology and Operative Intensive Care, Westfalian Wilhelms University, Münster, Federal Republic of Germany

    H. Van Aken, C. Anger & P. Lawin

  2. Neurosurgical University Clinic, Westfalian Wilhelms University, Münster, Federal Republic of Germany

    J. Hidding

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  1. C. Puchstein
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  2. H. Van Aken
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  3. J. Hidding
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  4. C. Anger
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  5. P. Lawin
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Puchstein, C., Van Aken, H., Hidding, J. et al. Treatment of hypertension with labetalol in neurosurgical practice. Acta neurochir 67, 283–290 (1983). https://doi.org/10.1007/BF01401430

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