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. 2023 Jul 3:10:1186041.
doi: 10.3389/fmed.2023.1186041. eCollection 2023.

Dose-response study of prophylactic nitroglycerin for prevention of pituitrin-induced hypertension during laparoscopic myomectomy: a prospective, randomized study

Jin Wang  1   2 , Qiang Xu  1   2 , Fei Xiao  2 , Gang Chen  1
Affiliations

Dose-response study of prophylactic nitroglycerin for prevention of pituitrin-induced hypertension during laparoscopic myomectomy: a prospective, randomized study

Jin Wang et al. Front Med (Lausanne). .

Abstract

Objective: To determine the dose-response of nitroglycerin in preventing pituitrin-induced hypertension in patients undergoing laparoscopic myomectomy.

Methods: Hundred patients scheduled for elective laparoscopic myomectomy were randomly allocated into one of five groups (n = 20) to receive intravenous bolus of prophylactic nitroglycerin at 0, 50, 75, 100, and 125 μg one minute following administration of 3 IU of pituitrin into the myometrium. The patients were monitored for pituitrin-induced hypertension with the primary outcome to determine the effective dose of prophylactic nitroglycerin, defined as complete prevention of pituitrin-induced hypertension during the study period. Probit analysis was used to calculate the median effective dose (ED50) and 95% effective dose (ED95) of prophylactic nitroglycerin.

Results: Hypertension occurred in 19/20, 10/20, 8/20, 2/20, and 1/20 in patients who received 0, 50, 75, 100, and 125 ug of prophylactic nitroglycerin, respectively. The calculated ED50 and ED95 of nitroglycerin for preventing hypertension were 54 μg (95%CI: 35~66 μg) and 136 μg (95%CI: 105~289 μg).

Conclusion: A prophylactic bolus of nitroglycerin administered immediately following injection of pituitrin into the myometrium during laparoscopic myomectomy effectively prevented pituitrin-induced hypertension, with the ED50 and ED95 of 54 μg and 136 μg, respectively. This information would be useful for clinical practice.

Clinical trial registration: www.chictr.org.cn, Identifier ChiCTR2200062282.

Keywords: hypertension; laparoscopy; leiomyoma; nitroglycerin; pituitrin.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Consolidated standards of reporting trials diagram showing patient recruitment and flow.
Figure 2
Figure 2
Dose–response curve of nitroglycerin for prevention of pituitrin-induced hypertension during laparoscopic myomectomy. The gray dots on the curve represent the ED50 and ED95 values of nitroglycerin for preventing pituitrin-induced hypertension, and the values were 54 μg (95%CI:35~66 μg) and 136 μg (95%CI: 105~289 μg), respectively.
See this image and copyright information in PMC

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