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The Annals of Thoracic Surgery, Vol 56, 1035-1037, Copyright © 1993 by The Society of Thoracic Surgeons
AC Cernaianu, A Olah, JH Cilley Jr, T Gaprindashvili, JG Gallucci and AJ DelRossi
Sodium nitroprusside (SNP) is usually used to control excessive proximal
pressure after aortic cross-clamping. To assess the effect of SNP on
circulatory dynamics, somatosensory evoked potentials, and neurologic
outcome, 10 adult mongrel dogs that underwent 45 minutes of cross-clamping
of the thoracic aorta were randomly assigned to receive either 50 mg/kg of
SNP or no treatment for excessive proximal hypertension. There was a
statistically significant difference noted between the SNP-treated animals
and the control animals in terms of the proximal mean arterial pressures
(112 +/- 13 versus 142.2 +/- 15 mm Hg, respectively; p < 0.05) and the
mean distal arterial pressures (15 +/- 3 mm Hg versus 23 +/- 1 mm Hg; p =
0.04). However, the electrical activity of the spinal cord, as indicated by
the somatosensory evoked potentials, returned significantly faster in the
nontreated group than in the SNP-treated group (15 +/- 9 versus 44 +/- 13
minutes; p < 0.05). Control animals exhibited a significantly better
neurologic outcome and no paraplegia 24 hours postoperatively. We conclude
that the use of SNP to treat excessive proximal hypertension may be
detrimental to the spinal cord during cross-clamping of the thoracic aorta,
resulting in a decline in the ischemic tolerance.
ARTICLES
Effect of sodium nitroprusside on paraplegia during cross-clamping of the thoracic aorta
Division of Cardiothoracic Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden 08103.
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