AUTHOR=Wang Jin , Xu Qiang , Xiao Fei , Chen Gang 

TITLE=Dose–response study of prophylactic nitroglycerin for prevention of pituitrin-induced hypertension during laparoscopic myomectomy: a prospective, randomized study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1186041

DOI=10.3389/fmed.2023.1186041

ISSN=2296-858X

ABSTRACT=Objective To determine the dose-response of nitroglycerin in preventing pituitrin-induced hypertension in patients undergoing laparoscopic myomectomy.Methods 100 patients scheduled for elective laparoscopic myomectomy were randomly allocated into one of five groups (n=20) to receive intravenous bolus of prophylactic nitroglycerin at 0, 50, 75, 100, and 125μg one minute following administration of 3 IU of pituitrin into the myometrium. The patients were monitored for pituitrin-induced hypertension with the primary outcome to determine the effective dose of prophylactic nitroglycerin, defined as complete prevention of pituitrin-induced hypertension during the study period. Probit analysis was used to calculate the median effective dose (ED50) and 95% effective dose (ED95) of prophylactic nitroglycerin.Hypertension occurred in 19/20, 10/20, 8/20, 2/20 and 1/20 in patients who received 0, 50, 75, 100 and 125ug of prophylactic nitroglycerin, respectively. The calculated ED50 and ED95 of nitroglycerin for preventing hypertension were 54μg (95%CI: 35~66μg) and 136μg (95%CI: 105~289μg).A prophylactic bolus of nitroglycerin administered immediately following injection of pituitrin into the myometrium during laparoscopic myomectomy effectively prevented pituitrin-induced hypertension, with the ED50 and ED95 of 54μg and 136μg, respectively. This information would be useful for clinical practice.