This study examines the effects of esmolol (E) and sodium nitroprusside (SNP) in inducing hypotension during isoflurane (I) anesthesia. Nineteen men (E = 10, SNP = 9) undergoing genitourinary surgery were studied. Cardiovascular, endocrine (catecholamine levels and plasma renin activity [PRA]), and arterial blood gas data were collected before, during, and after hypotension employing infusions of SNP at 0.5, 1.0, or 2.0 μg/kg/min or E at 75, 150, or 300 μg/kg/min. The hypotensive agent and its dosage sequence were chosen randomly Compared with preinduction values, there was no difference in the PRA or the heart rate during hypotension in the E group, but in the SNP group, both increased significantly Furthermore, the authors also observed a linear, dose-dependent reduction in I requirement with increasing doses of SNP, whereas with E, the I requirement decreased only with the higher dose. Arterial oxygenation also worsened with SNP as compared with E during hypotension. The authors conclude that during I anesthesia, E appears to be a better agent than SNP for induced hypotension.
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