The control of hypertension with dibutyryl cyclic AMP under general anesthesia
Sugai, Y.; Sugai, K.; Sawa, T.; Chihara, E.; Uchida, E.; Miyazaki, M.
Masui. Japanese Journal of Anesthesiology 35(10): 1499-1504
1986
ISSN/ISBN: 0021-4892 PMID: 3027428 Document Number: 275637
In 36 patients, who developed hypertension over 160 mm Hg of systolic arterial pressure during general anesthesia, the effects of rapid and large amount of administration of dibutyryl cyclic AMP (DBcAMP), a derivative of cyclic AMP, were studied to clarify its clinical vasodilatating action. DBcAMP was given intravenously with an infusion pump at a rate of 0.6 mg/kg/min for 20 minutes. Right after the infusion; the mean systolic arterial pressure decreased from 174.6 .+-. 11.9 to 130.0 .+-. 14.3 mmHg; diastolic pressure decreased from 94.3 .+-. 9.0 to 65.1 .+-. 7.8 mmHg; heart rate increased from 81.4 .+-. 11.0 to 91.9 .+-. 14.0 beats/min; urine volume increased from 68.1 .+-. 29.9 to 207.3 .+-. 93.3 ml/H; and cardiac index increased from 3.44 to 4.24 l/min/m2. In 7 cases, tachycardia of over 120 beats/min developed. In the cases of essential hypertension, DBcAMP exerted sufficient vasodilating action. With anesthesia using nitrous oxide-oxygen-enflurane, DBcAMP showed the most remarkable antihypertensive action. We speculate that DBcAMP is useful to control hypertension in the cases with cardiac failure, renal disorders or essential hypertension.