Nitrous Oxide for Blood Pressure Control after Coronary Artery Surgery: A Dose-Response Hemodynamic Study in Postoperative Patients

Verdi J. DiSesa, Jonathan B. Mark, Jeffrey P. Gold, Francis Kidwell, Richard J. Shemin, John J. Collins, Lawrence H. Cohn

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The inhaled anesthetic nitrous oxide is used for sedation in the coronary care unit and has been advocated as an antihypertensive agent in patients after a cardiac operation. To delineate the hemodynamic effects of nitrous oxide after cardiac surgery, we studied 11 patients with a mean age of 63 years who had undergone isolated coronary artery bypass grafting. All patients had major coronary artery disease and normal preoperative hemodynamic function. When patients were in stable condition in the intensive care unit, hemodynamic measurements were made at an inspired oxygen concentration of 40% with progressive doses of nitrous oxide (0, 10, 20, 40, and 60%). Measured and calculated hemodynamic data were compared using analysis of variance. Nitrous oxide caused significant decreases in mean arterial pressure in a dose-related fashion; pressure fell 6 mm Hg at 10% nitrous oxide and 11 mm Hg at 60% nitrous oxide (6 and 13% decreases). These changes were not associated with significant alteration in pulmonary artery pressure or cardiac index. Left ventricular stroke work index decreased significantly with the administration of nitrous oxide. We conclude that, in patients with normal hemodynamic and ventricular function, the administration of nitrous oxide for its sedative and antihypertensive effects is safe in the postoperative period and may be useful, especially in patients who are candidates for early extubation.

Original languageEnglish (US)
Pages (from-to)189-191
Number of pages3
JournalAnnals of Thoracic Surgery
Volume44
Issue number2
DOIs
StatePublished - Jan 1 1987

Fingerprint

Nitrous Oxide
Coronary Vessels
Hemodynamics
Blood Pressure
Antihypertensive Agents
Pressure
Coronary Care Units
Ventricular Function
Hypnotics and Sedatives
Postoperative Period
Coronary Artery Bypass
Pulmonary Artery
Thoracic Surgery
Intensive Care Units
Anesthetics
Coronary Artery Disease
Analysis of Variance
Arterial Pressure
Stroke
Oxygen

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Nitrous Oxide for Blood Pressure Control after Coronary Artery Surgery : A Dose-Response Hemodynamic Study in Postoperative Patients. / DiSesa, Verdi J.; Mark, Jonathan B.; Gold, Jeffrey P.; Kidwell, Francis; Shemin, Richard J.; Collins, John J.; Cohn, Lawrence H.

In: Annals of Thoracic Surgery, Vol. 44, No. 2, 01.01.1987, p. 189-191.

Research output: Contribution to journalArticle

DiSesa, Verdi J. ; Mark, Jonathan B. ; Gold, Jeffrey P. ; Kidwell, Francis ; Shemin, Richard J. ; Collins, John J. ; Cohn, Lawrence H. / Nitrous Oxide for Blood Pressure Control after Coronary Artery Surgery : A Dose-Response Hemodynamic Study in Postoperative Patients. In: Annals of Thoracic Surgery. 1987 ; Vol. 44, No. 2. pp. 189-191.
@article{012540aecd5f4798bc381f458041eff2,
title = "Nitrous Oxide for Blood Pressure Control after Coronary Artery Surgery: A Dose-Response Hemodynamic Study in Postoperative Patients",
abstract = "The inhaled anesthetic nitrous oxide is used for sedation in the coronary care unit and has been advocated as an antihypertensive agent in patients after a cardiac operation. To delineate the hemodynamic effects of nitrous oxide after cardiac surgery, we studied 11 patients with a mean age of 63 years who had undergone isolated coronary artery bypass grafting. All patients had major coronary artery disease and normal preoperative hemodynamic function. When patients were in stable condition in the intensive care unit, hemodynamic measurements were made at an inspired oxygen concentration of 40{\%} with progressive doses of nitrous oxide (0, 10, 20, 40, and 60{\%}). Measured and calculated hemodynamic data were compared using analysis of variance. Nitrous oxide caused significant decreases in mean arterial pressure in a dose-related fashion; pressure fell 6 mm Hg at 10{\%} nitrous oxide and 11 mm Hg at 60{\%} nitrous oxide (6 and 13{\%} decreases). These changes were not associated with significant alteration in pulmonary artery pressure or cardiac index. Left ventricular stroke work index decreased significantly with the administration of nitrous oxide. We conclude that, in patients with normal hemodynamic and ventricular function, the administration of nitrous oxide for its sedative and antihypertensive effects is safe in the postoperative period and may be useful, especially in patients who are candidates for early extubation.",
author = "DiSesa, {Verdi J.} and Mark, {Jonathan B.} and Gold, {Jeffrey P.} and Francis Kidwell and Shemin, {Richard J.} and Collins, {John J.} and Cohn, {Lawrence H.}",
year = "1987",
month = "1",
day = "1",
doi = "10.1016/S0003-4975(10)62039-5",
language = "English (US)",
volume = "44",
pages = "189--191",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Nitrous Oxide for Blood Pressure Control after Coronary Artery Surgery

T2 - A Dose-Response Hemodynamic Study in Postoperative Patients

AU - DiSesa, Verdi J.

AU - Mark, Jonathan B.

AU - Gold, Jeffrey P.

AU - Kidwell, Francis

AU - Shemin, Richard J.

AU - Collins, John J.

AU - Cohn, Lawrence H.

PY - 1987/1/1

Y1 - 1987/1/1

N2 - The inhaled anesthetic nitrous oxide is used for sedation in the coronary care unit and has been advocated as an antihypertensive agent in patients after a cardiac operation. To delineate the hemodynamic effects of nitrous oxide after cardiac surgery, we studied 11 patients with a mean age of 63 years who had undergone isolated coronary artery bypass grafting. All patients had major coronary artery disease and normal preoperative hemodynamic function. When patients were in stable condition in the intensive care unit, hemodynamic measurements were made at an inspired oxygen concentration of 40% with progressive doses of nitrous oxide (0, 10, 20, 40, and 60%). Measured and calculated hemodynamic data were compared using analysis of variance. Nitrous oxide caused significant decreases in mean arterial pressure in a dose-related fashion; pressure fell 6 mm Hg at 10% nitrous oxide and 11 mm Hg at 60% nitrous oxide (6 and 13% decreases). These changes were not associated with significant alteration in pulmonary artery pressure or cardiac index. Left ventricular stroke work index decreased significantly with the administration of nitrous oxide. We conclude that, in patients with normal hemodynamic and ventricular function, the administration of nitrous oxide for its sedative and antihypertensive effects is safe in the postoperative period and may be useful, especially in patients who are candidates for early extubation.

AB - The inhaled anesthetic nitrous oxide is used for sedation in the coronary care unit and has been advocated as an antihypertensive agent in patients after a cardiac operation. To delineate the hemodynamic effects of nitrous oxide after cardiac surgery, we studied 11 patients with a mean age of 63 years who had undergone isolated coronary artery bypass grafting. All patients had major coronary artery disease and normal preoperative hemodynamic function. When patients were in stable condition in the intensive care unit, hemodynamic measurements were made at an inspired oxygen concentration of 40% with progressive doses of nitrous oxide (0, 10, 20, 40, and 60%). Measured and calculated hemodynamic data were compared using analysis of variance. Nitrous oxide caused significant decreases in mean arterial pressure in a dose-related fashion; pressure fell 6 mm Hg at 10% nitrous oxide and 11 mm Hg at 60% nitrous oxide (6 and 13% decreases). These changes were not associated with significant alteration in pulmonary artery pressure or cardiac index. Left ventricular stroke work index decreased significantly with the administration of nitrous oxide. We conclude that, in patients with normal hemodynamic and ventricular function, the administration of nitrous oxide for its sedative and antihypertensive effects is safe in the postoperative period and may be useful, especially in patients who are candidates for early extubation.

UR - http://www.scopus.com/inward/record.url?scp=0023193921&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023193921&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(10)62039-5

DO - 10.1016/S0003-4975(10)62039-5

M3 - Article

C2 - 3497618

AN - SCOPUS:0023193921

VL - 44

SP - 189

EP - 191

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 2

ER -