Key result
Esmolol shows no significant benefit over sodium nitroprusside for hypertension after coarctation repair.
Why the study?
Postoperative arterial hypertension after repair of coarctation of the aorta requires effective treatment, but comparative efficacy of nitroprusside versus esmolol was unclear.
RCT (n=13)
Esmolol may control postoperative hypertension more reliably than nitroprusside; leaves open superiority in larger trials.
Postoperative arterial hypertension was treated with nitroprusside or esmolol in a prospective randomized study. If treatment failed, patients were first switched over to the other study drug, and then to a combination of both. Renin, angiotensin II, epinephrine, and norepinephrine were measured before, 1, and 17 h after operation. esmolol was effective in all cases of treatment (n=6) whereas nitroprusside was ineffective in two out of seven patients (not significant), who were finally treated effectively with the combination of the study drugs. Whenever monotherapy failed, both drugs together were effective in reducing the postoperative activation of the sympathetic and renin-angiotensin systems.
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Dittrich et al. (2003) conducted an RCT in Postoperative arterial hypertension following repair of coarctation of the aorta (n=13). Esmolol vs. Sodium nitroprusside was evaluated on Treatment effectiveness for postoperative arterial hypertension (p=not significant).
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