STUDIES OF ANAESTHESIA IN RELATION TO HYPERTENSION V: ADRENERGIC BETA-RECEPTOR BLOCKADE

The effects of intravenous practolol 0.4 mg/kg were studied in 12 hypertensive patients during halothane/nitrous oxide anaesthesia. Practolol decreased heart rate (HR) and cardiac output $(Q˙)$ from the elevated levels following atropine administration during anaesthesia, but values of arterial pressure (AP), HR and $Q˙$ after the combination of atropine and practolol were not significantly different from those during anaesthesia prior to blockade. The effects of a similar anaesthetic sequence were studied in a further 11 treated hypertensive patients given practolol by mouth 1.5 mg/kg/6 hours for at least 48 hours preoperatively in addition to current anti-hypertensive therapy. By comparison with treated hypertensive patients previously studied, those pretreated with practolol had similar AP awake, but higher AP throughout anaesthesia with either spontaneous or artificial ventilation. Cardiac output was higher and systemic vascular resistance was lower both before and during anaesthesia. Both the present groups of patients showed significantly attenuated responses of tachycardia and hypertension following laryngoscopy and intubation compared with previous studies. The incidence of dysrhythmia and e.c.g. evidence of myocardial ischaemia was significantly lower (4%) in beta-blocked patients compared with those who had not received practolol (38%).