[Sodiumnitroprusside in neurosurgery and intensive care of neurosurgical patients (author's transl)]

Abstract

Sodium nitroprusside (Nipride) was used in 35 patients between 16 and 72 years for induced hypotension. The fast and dose-dependent effect on the smooth muscles of the vessels made it superior to other methods of lowering blood pressure. Sodium nitroprusside was used to achieve hypotension in 11 patients (group I) with an aneurysm of a cerebral vessel and in 16 patients (group II) with highly vascularized cerebral tumors. In 8 patients (group III) from the neurosurgical intensive care unit a hypertensive crisis was interrupted. 10 patients (group IV) without induced hypotension were used as controls to compare the action of our standardized method of anesthesia on the observed parameters of blood pressure lowering. The average dose of sodium nitroprusside was 2.74 mcg/kg/min. in group I, 1.77 mcg/kg/min in group II and 1.27 mcg/kg/min in group III. The initial blood pressure was lowered between 30--40% in the mean in all 3 groups. Careful monitoring of the intra-arterial blood pressure, the central venous pressure, the cerebral fluid pressure, the arterial blood gases and the function of the kidneys during and after induced hypotension with sodium nitroprusside made it possible to take advantage of the blood pressure lowering effect also in patients with increased intracranial pressure.