Evaluating hemodynamic outcomes of different dosages of intravenous nitroglycerin after coronary artery bypass graft surgery

Hemodynamic deterioration is a common postoperative problem. Intravenous nitroglycerin (NTG) is used for prevention of this complication. Nitroglycerin has different doses and is primarily a vasodilator. Applying different doses of intravenous NTG can induce different effects on post-operative cardiac instability, so we aimed to investigate whether there was a difference need for administration of inotrope drugs in patients undergoing CABG as indicators of cardiac instability. Sixty seven consecutive patients enrolled in this double-blind clinical trial performed in Shahid Rajaee hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. The decrease in blood pressure and the need for administration of epinephrine was more prevalent in warming up period in all three groups. No need for administration of epinephrine was detected before and during anesthesia in groups receiving 100 and 150 μg/min intravenous nitroglycerin, but 6.6 percent (1 patient) of patients receiving 50 μg/min epinephrine, demonstrated a decrease in blood pressure which necessitated the use of epinephrine. It seemed that application of different doses of intravenous nitroglycerin did not exert a significant influence on cardiac instability and the need for use of inotrope drugs.