A comparison of two different doses of sildenafil in pulmonary arterial hypertension – a prospective randomised controlled study

Journal Title: Indian Journal of Clinical Anaesthesia - Year 2017, Vol 4, Issue 4

Abstract

Introduction: Sildenafil is an inhibitor of phosphodiesterase 5. Pulmonary vascular resistance caused by pulmonary artery hypertension can be relieved by sildenafil which causes rapid and potent vasodilatation. Materials and Method: Following institutional ethics committee approval, forty patients (using EPI calculator@openepi.com taking the power of study as 80% and -error as 5%) were randomised into two groups. If pulmonary arterial hypertension developed pre-operatively, group A received sildenafil 20mg while group B received sildenafil 40mg. The drug was administered in normal saline with the volume totaling to 50ml. Monitoring was done by cardioscope, SPO2, non-invasive blood pressure (NIBP). Heart rate (HR), systolic and diastolic blood pressures (SBP, DBP), respiratory rate (RR), SPO2 and pulmonary artery pressure were recorded preoperatively (baseline). Any expected and unexpected complications were looked for. Vitals were recorded before shifting the patient to the ward. Results: Heart rate and oxygen saturation did not show any statistical difference between the two groups. Post-operatively, group A displayed a pulmonary artery pressure of 30.45±5.65mmHg while for group B it was 30.62±6.74mmHg with a statistically significant difference (p-value<0.0001) but no statistically significant difference was seen during the pre-operative and intra-operative period. Hypotension was observed in three (15%) patients from group A and two (10%) patients from group B. Two (10%) patients in group A had bradycardia. Group B did not suffer from bradycardia at any point of time. Conclusion: Sildenafil is safe and efficacious for controlling pulmonary artery hypertension. 40mg sildenafil displayed a better control than a dose of 20mg sildenafil.

Authors and Affiliations

Rahul Mamde, Manjula Sarkar

Keywords

Related Articles

A comparative study between inj. ropivacaine 0.75% and inj.ropivacaine 0.75% with inj. dexmedetomidine in lumbar epidural anesthesia for vaginal hysterectomies

Introduction: Regional anesthesia has lots of advantages compared to general anesthesia for Vaginal hysterectomy. Intrathecal anesthesia and Epidural anaesthesia are regional anaesthesia techniques used for Vaginal Hyste...

A randomized controlled study of intraperitoneal vs intraincisional infiltration of local anesthetic levobupivacaine for pain relief in post-laparoscopic hysterectomy cases

Introduction and Aim: Providing postoperative pain relief is a common acceptable practice in modern era. Multimodal combination methods are being used to reduce opioid-related side effects. We conducted a randomized stud...

Efficacy of dexmedetomidine premedication on attenuation of intraocular pressure changes after succinylcholine and endotracheal intubation

Introduction: Succinylcholine, is one of the most commonly used muscle relaxant for rapid sequence airway management. It increases the Intraocular pressure (IOP) which is deleterious in open globe injuries. We studied th...

Effects of addition of fentanyl and midazolam to local anaesthetic in lumbar epidural anaesthesia for infraumbilical surgeries

Introduction: Compared to general anaesthesia, regional anaesthetic techniques are more preferred in lower limb and lower abdominal surgeries as they have many advantages. Fentanyl a short acting opioid agonist, acts at...

Comparative evaluation of the clinical efficacy of 0.5% levobupivacaine and 0.5% racemic bupivacaine in epidural anaesthesia for elective varicose vein surgery

Background and Aim: Racemic bupivacaine is known to be the most cardio toxic among the amide local anaesthetic. In search of an alternative it was found that the levo enantiomer has a better safety profile. This purpose...

Download PDF file
  • EP ID EP315028
  • DOI 10.18231/2394-4994.2017.0094
  • Views 50
  • Downloads 0

How To Cite

Rahul Mamde, Manjula Sarkar (2017). A comparison of two different doses of sildenafil in pulmonary arterial hypertension – a prospective randomised controlled study. Indian Journal of Clinical Anaesthesia, 4(4), 472-475. https://europub.co.uk/articles/-A-315028