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Comparative hemodynamic effects of labetalol and hydralazine in the treatment of postoperative hypertension.

Author(s): Dimich I, Lingham R, Gabrielson G, Singh PP, Kaplan JA

Affiliation(s): Department of Anesthesiology, Mount Sinai School of Medicine, (CUNY), New York 10029-6574.

Publication date & source: 1989, J Clin Anesth., 1(3):201-6.

Publication type: Clinical Trial; Comparative Study ; Randomized Controlled Trial

The antihypertensive efficacy and safety of IV labetalol were evaluated and compared with the efficacy and safety of IV hydralazine in the treatment of postoperative hypertension. Twenty patients undergoing major noncardiac surgery were entered into the study. Patients were randomized and treated for postoperative hypertension with either labetalol (n = 10) or hydralazine (n = 10). Labetalol and hydralazine both produced significant reductions in arterial blood pressure (p less than 0.001) within 10 minutes, which lasted at least 2 hours. In addition, labetalol produced a significant reduction in the heart rate and rate-pressure product without creating any adverse effects. In contrast, hydralazine produced significant sinus tachycardia requiring IV propranolol in three patients, two of whom developed transient ST segment depression. These results indicate that labetalol is safe and effective for the control of postoperative hypertension, especially in those patients who are least able to tolerate tachycardia.

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