Fenoldopam infusion for the treatment of postoperative hypertension

Goldberg, Michael E.; Cantillo, Joaquin; Nemiroff, Mark S.; Subramoni, Jaya; Muñoz, Raúl; Torjman, Marc C.; Schieren, Hugh

doi:10.1016/0952-8180(93)90102-k

Cited by 27 publications

(9 citation statements)

References 18 publications

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“…In a phase 2 trial involving 16 patients with postoperative hypertension, defined as a systolic or diastolic blood pressure while supine that is 20 percent higher than the preoperative base-line value, 8 patients were given fenoldopam starting at a dose of 0.1 µg per kilogram per minute with increases as needed to reduce blood pressure to less than 10 percent above the preoperative level, and 8 patients were given placebo. 67 All eight patients who were given fenoldopam had the desired reduction in blood pressure at infusion rates of less than 1.5 µg per kilogram per minute. Four patients given placebo had similar reductions in blood pressure, but the effect was not sustained.…”

Section: Fenoldopam For Hypertension During the Perioperative Periodmentioning

confidence: 95%

Fenoldopam — A Selective Peripheral Dopamine-Receptor Agonist for the Treatment of Severe Hypertension

2001

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Section: Fenoldopam For Hypertension During the Perioperative Periodmentioning

confidence: 95%

Fenoldopam — A Selective Peripheral Dopamine-Receptor Agonist for the Treatment of Severe Hypertension

2001

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“…The current series of patients demonstrates that fenoldopam is an effective pharmacological agent for controlled hypotension. Previous experience with this agent has centred on its use in adult patients with hypertensive emergencies and for the treatment of postoperative hypertension ( 8,11). In a prospective, randomized study, Panacek et al .…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have demonstrated the efficacy of fenoldopam in controlling MAP in adult patients with hypertensive emergencies and during the postoperative period ( 7,8). However, there are currently no reports outlining its use for controlled hypotension.…”

Section: Introductionmentioning

confidence: 99%

Fenoldopam for controlled hypotension during spinal fusion in children and adolescents

Tobias

2000

Pediatric Anesthesia

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Fenoldopam is a dopamine1 agonist whose pharmacological effects include vasodilation of the vascular beds of the kidney, mesentery, skeletal muscle, and coronary systems, resulting in a decrease in systemic vascular resistance and mean arterial pressure. The current retrospective review outlines the use of fenoldopam for controlled hypotension during anterior or posterior spinal fusion in 10 children and adolescents, aged 8-14 years and weighing 22-61 kg. Fenoldopam was infused at a starting dose of 0.3-0.5 microg.kg-1. min-1 and increased incrementally to achieve a mean arterial pressure (MAP) of 50-65 mmHg. The desired MAP was achieved in 4-11 min (7+/-2.5 min). The fenoldopam infusion was administered for 135-225 min (160+/-25 min) in doses ranging from 0.2 to 2.5 microg. kg-1.min-1. The mean fenoldopam infusion rate for the 10 cases varied from 0.5 to 1.4 microg.kg-1.min-1 (1.0+/-0.3 microg.kg-1. min-1). No excessive hypotension or clinically significant adverse effects were noted. Statistically significant, but clinically insignificant, increases in heart rate and decreases in PaO2 were noted during the fenoldopam infusion. The baseline heart rate increased from 87+/-13 b.min-1 to a maximum of 114+/-16 b.min-1 (P < 0.0001) during the fenoldopam infusion. In the six patients undergoing posterior spinal fusion, the baseline PaO2 decreased from 232+/-7 mmHg to a low of 199+/-11 mmHg (P=0.0004) during the fenoldopam infusion. Fenoldopam can be used to provide controlled hypotension during spinal surgery in children and adolescents. Future studies, with direct comparison to other commonly used agents, are needed to better define its advantages and disadvantages as well as its effects on estimated blood loss.

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“…. Clinical studies suggest that the effi cacy of fenoldopam in decreasing blood pressure in patients with hypertensive urgency, including those with hypertension after coronary artery bypass grafting, is similar to that of sodium nitroprusside [28][29][30]. In contrast to nitroprusside, however, fenoldopam also increases renal perfusion, leading to enhanced diuresis and natriuresis.…”

Section: Clevidipinementioning

confidence: 92%

Strategies for managing perioperative hypertension

Desai

Muntazar

Goldberg

2009

Current Science Inc

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Acute perioperative hypertension is associated with a higher risk of perioperative myocardial ischemia, bleeding, stroke, and renal failure. The immediate concern of short-term antihypertensive therapy is to prevent excessive surgical bleeding from arterial anastomoses, myocardial ischemia, and neurologic complications while causing minimal adverse effects until oral therapy can be resumed. This article reviews perioperative hypertension emergencies/urgencies and various approaches for management.

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Fenoldopam infusion for the treatment of postoperative hypertension

Cited by 27 publications

References 18 publications

Fenoldopam — A Selective Peripheral Dopamine-Receptor Agonist for the Treatment of Severe Hypertension

Fenoldopam — A Selective Peripheral Dopamine-Receptor Agonist for the Treatment of Severe Hypertension

Fenoldopam for controlled hypotension during spinal fusion in children and adolescents

Strategies for managing perioperative hypertension

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