| Hypotensive Anesthesia using Propranolol and Hexamethonium . |
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Tae Inn Park, Ryung Choi, Hung Kun Oh |
1Department of Anesthesiology, Yonsei University Wonju College of Medicine, Wonju, Korea.
2Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea. |
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| Abstract |
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Hexamethonium with propranolol was used to produce hypotension in 3 selected patients, ages 45 to 56, for neck deasection with thyroidectomy, Mile's operration and total laryngectomy with radical neck dissection. These cases were promedicated by lorazepam, anesthesia was induced and intubated following propranolol, morphine, diazepam and alcuroninum, and maintained with halothane, nitrous oxide and oxygen. Respiration was controlled by an anesthesia ventilator. Following elevation of the operation site, small amount of hexamethonium was injected to produce a dry surgical field. Systolic blood pressure was maintained around 80mmHg. Average doses of hexamethonium used were 0.12mg/kghr and propranolol 0.5 to 1 mg respectively.
Judicious administration of sufficient doses of propranolol to lower the heart rate before and during hexamethonium induced hypotension reduces both the hexamethonium dose requirement and also the likelihood of developing individual variations in its effect. |
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