Evaluation of antihypertensive efficacy of intravenous labetalol versus oral nifedipine in preeclamptic hypertensive emergency : a randomised controlled trial.
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 5
Abstract
To compare oral nifedipine with intravenous labetalol in their rapidity to control preeclamptic hypertensive emergencies. The primary outcome is number of doses required to achieve a target blood pressure of <150/100 mmHg. This is a double blinded randomised controlled trial. Patients are randomised to receive nifedipine (10 mg tablet initially followed by 20mg tablet every 20 minutes, orally, up to five doses) and intravenous placebo saline injection or intravenous labetalol injection (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg) and a placebo tablet every 20 minutes until the target blood pressure of <150/100 mmHg is achieved. Crossover treatment is effected if the initial treatment regimen is unsuccessful. In this study 32 patients have been included in labetalol group and 28 patients in nifedipine group. Labetalol controls systolic BP in range of 170-180 mm Hg with fewer doses than nifedipine (70% with 1st dose by labetalol vs 33% with 1st dose by nifedipine). Similarly, labetalol controls diastolic BP in range of 110-120 mm Hg with fewer doses than nifedipine (76% with 1st dose by labetalol vs 47% with 1st dose by nifedipine). Overall, control of BP achieved with single dose in 78% of cases in labetalol group vs 39% of cases in nifedipine group. To compare with nifedipine, labetalol group has carried a better control of hypertension. Both systolic and diastolic blood pressure is controlled with fewer doses with labetalol.
Authors and Affiliations
Madhusudan Haldar, Shamim Khandaker, Dip Sarkar
Keywords
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