The effect of milrinone on induced hypotension in elderly patients during spinal surgery: a randomized controlled trial |
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Authors: | Wonjung Hwang Eunsung Kim |
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Affiliation: | 1. Gulf Coast Heart Clinic (MH), Houston, TX, USA;2. ICA Therapeutics, Houston, TX, USA;3. Department of Pharmacological and Pharmaceutical Sciences, University of Houston College of Pharmacy, Houston, TX 77036, USA;4. Cardiac Department, National University Heart Centre, National University Health System and Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;5. Division of Cardiovascular Medicine, Department of Medicine, University of Utah School of Medicine, UT 84132, USA |
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Abstract: | Background contextInduced hypotension is widely used intraoperatively to reduce blood loss and to improve the surgical field during spinal surgery.PurposeTo determine the effect of milrinone on induced hypotension during spinal surgery in elderly patients.Study design/settingProspective randomized clinical trial.Patient sampleForty patients, 60 to 70 years old, ASA I–II, who underwent elective lumbar fusion surgery.Outcome measuresIntraoperative hemodynamics, blood loss, hourly urine output, and grade of surgical field.MethodsAll patients were randomized to group M or N. The study drug was infused after perivertebral muscle retraction until complete interbody fusion. In group M, 50 μg/kg/min of milrinone was infused over 10 minutes as a loading dose followed by 0.6 μg/kg/min of milrinone as a continuous dose. In group N, an identical volume of normal saline was infused in the same fashion. This study was not funded by commercial or other sponsorship and the authors confirm no conflicts of interest, financial or otherwise.ResultsDuring infusion of the study drug, the systolic and mean blood pressures were maintained within adequate limits of induced hypotension in group M. Intraoperative blood loss was 445.0±226.5 mL in group M and 765.0±339.2 mL in group N (p=.001). Hourly urine output was 1.4±0.6 mL in group M and 0.8±0.2 mL in group N (p<.001). The grade of the surgical field was better in group M than in group N (p=.004).ConclusionsWe conclude that milrinone is useful for induced hypotension in elderly patients during spinal surgery. |
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Keywords: | Milrinone Induced hypotension Lumbar spinal surgery |
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