Simultaneous infusion of nitroglycerin and nitroprusside to offset adverse effects of vasopressin during portosystemic shunting

Kenneth R Sirinek, Deborah K. Adcock, Barry A. Levine

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

In the present study, 52 patients with cirrhosis, portal hypertension, and variceal hemorrhage underwent either an elective or an emergency side-to-side portacaval shunt operation. Vasopressin was infused intravenously at 60 units/hour from just prior to abdominal incision until completion of the anastomosis. Eight of 35 patients who received vasopressin alone (23 percent) tolerated increased doses of 75 to 90 units/hour to obtain hemostasis. Four of 52 patients required simultaneous infusion of sodium nitroprusside to correct systemic hypertension. An additional 15 percent reduction in portal venous pressure occurred in these patients. Eleven of 13 patients with vasopressin-induced myocardial ischemia responded to simultaneous infusion of nitroglycerin. Further prospective studies are indicated to adequately delineate the dose and duration of therapy with either nitroprusside or nitroglycerin for simultaneous administration with intravenous vasopressin.

Original languageEnglish (US)
Pages (from-to)33-37
Number of pages5
JournalThe American Journal of Surgery
Volume157
Issue number1
DOIs
StatePublished - 1989
Externally publishedYes

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Nitroglycerin
Nitroprusside
Vasopressins
Surgical Portacaval Shunt
Portal Pressure
Portal Hypertension
Hemostasis
Intravenous Administration
Myocardial Ischemia
Emergencies
Fibrosis
Prospective Studies
Hemorrhage
Hypertension

ASJC Scopus subject areas

  • Surgery

Cite this

Simultaneous infusion of nitroglycerin and nitroprusside to offset adverse effects of vasopressin during portosystemic shunting. / Sirinek, Kenneth R; Adcock, Deborah K.; Levine, Barry A.

In: The American Journal of Surgery, Vol. 157, No. 1, 1989, p. 33-37.

Research output: Contribution to journalArticle

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