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Contributions

The hemodynamic effects of intravenous labetalol for postoperative hypertension

James P. Orlowski, MD, Donald G. Vidt, MD, Sheryl Walker, MD and Joseph F. Haluska, DO
Cleveland Clinic Journal of Medicine January 1989, 56 (1) 29-34;
James P. Orlowski
Pediatric and Surgical Intensive Care Unit, Division of Anesthesiology, The Cleveland Clinic Foundation
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Donald G. Vidt
Department of Hypertension and Nephrology, The Cleveland Clinic Foundation
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Sheryl Walker
Pediatric and Surgical Intensive Care Unit, Division of Anesthesiology, The Cleveland Clinic Foundation
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Joseph F. Haluska
Pediatric and Surgical Intensive Care Unit, Division of Anesthesiology, The Cleveland Clinic Foundation
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ABSTRACT

Hemodynamic data were analyzed from 25 courses of intravenous pulse labetalol therapy for postoperative hypertension in 12 patients after major vascular surgeries. The hemodynamic determinations were obtained an average of 15 minutes after a therapeutic total dose of 10-120 mg of labetalol (mean, 37.5 mg). The mean arterial pressure (MAP) decreased an average of 27 mmHg or 20% after intravenous labetalol. This normalization of the postoperative hypertension was associated with a 19% increase in cardiac output (CO) and cardiac index (CI) (CO mean increase of 0.58 L/min and CI increase of 0.31 L/min/m2). Commensurate with this decrease in MAP and increase in C O was an average decrease in systemic vascular resistance (SVR) of 625 dyne/sec/cm−5 or 25%. The pulmonary vascular resistance decreased 15 dyne/sec/cm-5 or 4%. The heart rate decreased 9 beats per minute or 10% and the left ventricular stroke work improved by 9% or 1.6 g/m2/beat while the right ventricular stroke work increased by 33% or 2.8 g/m2/beat. The hemodynamic responses to intravenous labetalol in these patients were all beneficial, and there were no adverse effects secondary to the pulse doses of labetalol. Labetalol appears to be safe and efficacious for the treatment of postoperative hypertension in patients undergoing major vascular surgery.

INDEX TERMS
  • Hypertension
  • Labetalol
  • Received February 1988.
  • Accepted June 1988.
  • Copyright © 1989 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 56 (1)
Cleveland Clinic Journal of Medicine
Vol. 56, Issue 1
1 Jan 1989
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The hemodynamic effects of intravenous labetalol for postoperative hypertension
James P. Orlowski, Donald G. Vidt, Sheryl Walker, Joseph F. Haluska
Cleveland Clinic Journal of Medicine Jan 1989, 56 (1) 29-34;

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The hemodynamic effects of intravenous labetalol for postoperative hypertension
James P. Orlowski, Donald G. Vidt, Sheryl Walker, Joseph F. Haluska
Cleveland Clinic Journal of Medicine Jan 1989, 56 (1) 29-34;
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Keywords

  • Hypertension
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